IDEAS home Printed from https://ideas.repec.org/a/plo/pone00/0143910.html
   My bibliography  Save this article

(Un)Healthy in the City: Respiratory, Cardiometabolic and Mental Health Associated with Urbanity

Author

Listed:
  • Wilma L Zijlema
  • Bart Klijs
  • Ronald P Stolk
  • Judith G M Rosmalen

Abstract

Background: Research has shown that health differences exist between urban and rural areas. Most studies conducted, however, have focused on single health outcomes and have not assessed to what extent the association of urbanity with health is explained by population composition or socioeconomic status of the area. Our aim is to investigate associations of urbanity with four different health outcomes (i.e. lung function, metabolic syndrome, depression and anxiety) and to assess whether these associations are independent of residents’ characteristics and area socioeconomic status. Methods: Our study population consisted of 74,733 individuals (42% males, mean age 43.8) who were part of the baseline sample of the LifeLines Cohort Study. Health outcomes were objectively measured with spirometry, a physical examination, laboratory blood analyses, and a psychiatric interview. Using multilevel linear and logistic regression models, associations of urbanity with lung function, and prevalence of metabolic syndrome, major depressive disorder and generalized anxiety disorder were assessed. All models were sequentially adjusted for age, sex, highest education, household equivalent income, smoking, physical activity, and mean neighborhood income. Results: As compared with individuals living in rural areas, those in semi-urban or urban areas had a poorer lung function (β -1.62, 95% CI -2.07;-1.16), and higher prevalence of major depressive disorder (OR 1.65, 95% CI 1.35;2.00), and generalized anxiety disorder (OR 1.58, 95% CI 1.35;1.84). Prevalence of metabolic syndrome, however, was lower in urban areas (OR 0.51, 95% CI 0.44;0.59). These associations were only partly explained by differences in residents’ demographic, socioeconomic and lifestyle characteristics and socioeconomic status of the areas. Conclusions: Our results suggest a differential health impact of urbanity according to type of disease. Living in an urban environment appears to be beneficial for cardiometabolic health but to have a detrimental impact on respiratory function and mental health. Future research should investigate which underlying mechanisms explain the differential health impact of urbanity.

Suggested Citation

  • Wilma L Zijlema & Bart Klijs & Ronald P Stolk & Judith G M Rosmalen, 2015. "(Un)Healthy in the City: Respiratory, Cardiometabolic and Mental Health Associated with Urbanity," PLOS ONE, Public Library of Science, vol. 10(12), pages 1-11, December.
  • Handle: RePEc:plo:pone00:0143910
    DOI: 10.1371/journal.pone.0143910
    as

    Download full text from publisher

    File URL: https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0143910
    Download Restriction: no

    File URL: https://journals.plos.org/plosone/article/file?id=10.1371/journal.pone.0143910&type=printable
    Download Restriction: no

    File URL: https://libkey.io/10.1371/journal.pone.0143910?utm_source=ideas
    LibKey link: if access is restricted and if your library uses this service, LibKey will redirect you to where you can use your library subscription to access this item
    ---><---

    References listed on IDEAS

    as
    1. Saelens, B.E. & Sallis, J.F. & Black, J.B. & Chen, D., 2003. "Neighborhood-Based Differences in Physical Activity: An Environment Scale Evaluation," American Journal of Public Health, American Public Health Association, vol. 93(9), pages 1552-1558.
    2. Verheij, Robert A., 1996. "Explaining urban-rural variations in health: A review of interactions between individual and environment," Social Science & Medicine, Elsevier, vol. 42(6), pages 923-935, March.
    3. Florian Lederbogen & Peter Kirsch & Leila Haddad & Fabian Streit & Heike Tost & Philipp Schuch & Stefan Wüst & Jens C. Pruessner & Marcella Rietschel & Michael Deuschle & Andreas Meyer-Lindenberg, 2011. "City living and urban upbringing affect neural social stress processing in humans," Nature, Nature, vol. 474(7352), pages 498-501, June.
    Full references (including those not matched with items on IDEAS)

    Citations

    Citations are extracted by the CitEc Project, subscribe to its RSS feed for this item.
    as


    Cited by:

    1. Nina Rautio & Svetlana Filatova & Heli Lehtiniemi & Jouko Miettunen, 2018. "Living environment and its relationship to depressive mood: A systematic review," International Journal of Social Psychiatry, , vol. 64(1), pages 92-103, February.
    2. Zihan Kan & Mei-Po Kwan & Mee Kam Ng & Hendrik Tieben, 2022. "The Impacts of Housing Characteristics and Built-Environment Features on Mental Health," IJERPH, MDPI, vol. 19(9), pages 1-19, April.
    3. Motoc, Irina & Hoogendijk, Emiel O. & Timmermans, Erik J. & Deeg, Dorly & Penninx, Brenda W.J.H. & Huisman, Martijn, 2023. "Social and physical neighbourhood characteristics and 10-year incidence of depression and anxiety in older adults: Results from the Longitudinal Aging Study Amsterdam," Social Science & Medicine, Elsevier, vol. 327(C).

    Most related items

    These are the items that most often cite the same works as this one and are cited by the same works as this one.
    1. Alexander Karl Ferdinand Loder & Mireille Nicoline Maria van Poppel, 2019. "Sedentariness of College Students Is Negatively Associated with Perceived Neighborhood Greenness at Home, but Not at University," IJERPH, MDPI, vol. 17(1), pages 1-13, December.
    2. Anura Amarasinghe & Gerard D'Souza & Cheryl Brown & Tatiana Borisova, 2006. "A Spatial Analysis of Obesity in West Virginia," Working Papers Working Paper 2006-13, Regional Research Institute, West Virginia University.
    3. Spielman, Seth E. & Yoo, Eun-hye, 2009. "The spatial dimensions of neighborhood effects," Social Science & Medicine, Elsevier, vol. 68(6), pages 1098-1105, March.
    4. Kevin Credit & Elizabeth Mack, 2019. "Place-making and performance: The impact of walkable built environments on business performance in Phoenix and Boston," Environment and Planning B, , vol. 46(2), pages 264-285, February.
    5. Mi Namgung & B. Elizabeth Mercado Gonzalez & Seungwoo Park, 2019. "The Role of Built Environment on Health of Older Adults in Korea: Obesity and Gender Differences," IJERPH, MDPI, vol. 16(18), pages 1-13, September.
    6. Courtney Coughenour & Hanns de la Fuente-Mella & Alexander Paz, 2019. "Analysis of Self-Reported Walking for Transit in a Sprawling Urban Metropolitan Area in the Western U.S," Sustainability, MDPI, vol. 11(3), pages 1-16, February.
    7. Eric T. H. Chan & Tim Schwanen & David Banister, 2021. "The role of perceived environment, neighbourhood characteristics, and attitudes in walking behaviour: evidence from a rapidly developing city in China," Transportation, Springer, vol. 48(1), pages 431-454, February.
    8. McNeill, Lorna Haughton & Kreuter, Matthew W. & Subramanian, S.V., 2006. "Social Environment and Physical activity: A review of concepts and evidence," Social Science & Medicine, Elsevier, vol. 63(4), pages 1011-1022, August.
    9. Larissa Samaan & Leonie Klock & Sandra Weber & Mirjam Reidick & Leonie Ascone & Simone Kühn, 2024. "Low-Level Visual Features of Window Views Contribute to Perceived Naturalness and Mental Health Outcomes," IJERPH, MDPI, vol. 21(5), pages 1-35, May.
    10. Fernando Fonseca & Escolástica Fernandes & Rui Ramos, 2022. "Walkable Cities: Using the Smart Pedestrian Net Method for Evaluating a Pedestrian Network in Guimarães, Portugal," Sustainability, MDPI, vol. 14(16), pages 1-23, August.
    11. Chorong Song & Harumi Ikei & Bum-Jin Park & Juyoung Lee & Takahide Kagawa & Yoshifumi Miyazaki, 2018. "Psychological Benefits of Walking through Forest Areas," IJERPH, MDPI, vol. 15(12), pages 1-10, December.
    12. repec:rri:wpaper:200613 is not listed on IDEAS
    13. Kent, Jennifer L. & Mulley, Corinne & Stevens, Nick, 2020. "Challenging policies that prohibit public transport use: Travelling with pets as a case study," Transport Policy, Elsevier, vol. 99(C), pages 86-94.
    14. Migle Baceviciene & Rasa Jankauskiene, 2022. "The Mediating Effect of Nature Restorativeness, Stress Level, and Nature Connectedness in the Association between Nature Exposure and Quality of Life," IJERPH, MDPI, vol. 19(4), pages 1-15, February.
    15. Victor O. Akande & Robert A.C. Ruiter & Stef P.J. Kremers, 2019. "Environmental and Motivational Determinants of Physical Activity among Canadian Inuit in the Arctic," IJERPH, MDPI, vol. 16(13), pages 1-14, July.
    16. Letizia Appolloni & Maria Vittoria Corazza & Daniela D’Alessandro, 2019. "The Pleasure of Walking: An Innovative Methodology to Assess Appropriate Walkable Performance in Urban Areas to Support Transport Planning," Sustainability, MDPI, vol. 11(12), pages 1-26, June.
    17. Jun-Hyun Kim & Chanam Lee & Wonmin Sohn, 2016. "Urban Natural Environments, Obesity, and Health-Related Quality of Life among Hispanic Children Living in Inner-City Neighborhoods," IJERPH, MDPI, vol. 13(1), pages 1-15, January.
    18. Park, Sungjin, 2008. "Defining, Measuring, and Evaluating Path Walkability, and Testing Its Impacts on Transit Users’ Mode Choice and Walking Distance to the Station," University of California Transportation Center, Working Papers qt0ct7c30p, University of California Transportation Center.
    19. Razieh Zandieh & Javier Martinez & Johannes Flacke & Phil Jones & Martin Van Maarseveen, 2016. "Older Adults’ Outdoor Walking: Inequalities in Neighbourhood Safety, Pedestrian Infrastructure and Aesthetics," IJERPH, MDPI, vol. 13(12), pages 1-24, November.
    20. Jake M. Robinson & Martin F. Breed, 2019. "Green Prescriptions and Their Co-Benefits: Integrative Strategies for Public and Environmental Health," Challenges, MDPI, vol. 10(1), pages 1-14, January.
    21. Guillem Artigues & Sara Mateo & Maria Ramos & Elena Cabeza, 2020. "Validation of the Urban Walkability Perception Questionnaire (UWPQ) in the Balearic Islands," IJERPH, MDPI, vol. 17(18), pages 1-16, September.

    More about this item

    Statistics

    Access and download statistics

    Corrections

    All material on this site has been provided by the respective publishers and authors. You can help correct errors and omissions. When requesting a correction, please mention this item's handle: RePEc:plo:pone00:0143910. See general information about how to correct material in RePEc.

    If you have authored this item and are not yet registered with RePEc, we encourage you to do it here. This allows to link your profile to this item. It also allows you to accept potential citations to this item that we are uncertain about.

    If CitEc recognized a bibliographic reference but did not link an item in RePEc to it, you can help with this form .

    If you know of missing items citing this one, you can help us creating those links by adding the relevant references in the same way as above, for each refering item. If you are a registered author of this item, you may also want to check the "citations" tab in your RePEc Author Service profile, as there may be some citations waiting for confirmation.

    For technical questions regarding this item, or to correct its authors, title, abstract, bibliographic or download information, contact: plosone (email available below). General contact details of provider: https://journals.plos.org/plosone/ .

    Please note that corrections may take a couple of weeks to filter through the various RePEc services.

    IDEAS is a RePEc service. RePEc uses bibliographic data supplied by the respective publishers.