Perceived built environment, health-related quality of life and health care utilization

PLoS One. 2021 May 6;16(5):e0251251. doi: 10.1371/journal.pone.0251251. eCollection 2021.

Abstract

Previous research has shown that the built environment plays a crucial role for health-related quality of life (HRQoL) and health care utilization. But, there is limited evidence on the independence of this association from lifestyle and social environment. The objective of this cross-sectional study was to investigate these associations, independent of the social environment, physical activity and body mass index (BMI). We used data from the third follow-up of the Swiss study on Air Pollution and Lung and Heart diseases In Adults (SAPALDIA), a population based cohort with associated biobank. Covariate adjusted multiple quantile and polytomous logistic regressions were performed to test associations of variables describing the perceived built environment with HRQoL and health care utilization. Higher HRQoL and less health care utilization were associated with less reported transportation noise annoyance. Higher HRQoL was also associated with greater satisfaction with the living environment and more perceived access to greenspaces. These results were independent of the social environment (living alone and social engagement) and lifestyle (physical activity level and BMI). This study provides further evidence that the built environment should be designed to integrate living and green spaces but separate living and traffic spaces in order to improve health and wellbeing and potentially save health care costs.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Air Pollution / adverse effects
  • Air Pollution / statistics & numerical data
  • Body Mass Index
  • Built Environment / psychology*
  • Cross-Sectional Studies
  • Exercise
  • Female
  • Humans
  • Male
  • Middle Aged
  • Patient Acceptance of Health Care / psychology
  • Patient Acceptance of Health Care / statistics & numerical data*
  • Quality of Life* / psychology
  • Social Environment
  • Switzerland

Grants and funding

This research was supported by the Swiss National Science Foundation (grants no 33CS30-177506/1). The study could not have been done without the help of the study participants, technical and administrative support and the medical teams and field workers at the local study sites.