Assessing the health impacts of the urban expansion of small cities in China: A case study of Jiawang

Empirical studies undertaken in developed countries have shown that urban expansion may exert both positive and negative impacts on residents' health, depending on the planning strategy; however, the impact of rapid urban expansion on public health in developing countries is understudied. This paper takes Jiawang, China, as an example of rapid urban expansion and carries out a health impact assessment (HIA) on its regulatory detailed plan to better understand the interaction of the built environment and public health. We establish an HIA framework and select a series of indicators as health determinants. On this basis, we examine what impact the urban expansion will exert on the health equity of the residents by conducting a bivariate spatial autocorrelation. The finding shows that:1) Urban expansion produces positive health impact through the health determinants of public facilities, road transportation and land use. 2) Urban expansion will reduce health disparities between the old and new town and between the urban and suburban areas, especially between the old and new town. 3) The impact of expansion exerts on health equity will be generally positive. Low-income neighborhoods in the old town will significantly benefit from urban expansion in terms of road traffic and land use, but will not fully benefit in terms of public facilities. Low-income neighborhoods will no longer benefit from the accessibility to commercial facilities and will suffer from health inequities in terms of accessibility to healthcare facilities. 4) The government's development strategy of emphasizing on an even distribution of public resources will unintentionally contribute to improving health equity. The significant promotion of health equity will mitigate the negative impacts of the previous urban development.