Spatially heterogeneous associations between the built environment and objective health outcomes in Japanese cities

Int J Environ Health Res. 2023 Dec;33(12):1205-1217. doi: 10.1080/09603123.2022.2083086. Epub 2022 Jun 7.

Abstract

The built environment is a structural determinant of health. Here we reveal spatially heterogeneous associations of built environment indicators with objective health outcomes (morbidity) by combining a random forest (RF) approach and a multiscale geographically weighted (MGWR) regression method. Using data from six Japanese cities, we found that the ratio of morbidity has obvious spatial agglomerations. The mixed land-use diversity with 1000 m buffer, distance to hospital, proportion of park area with 300 m buffer, and house price with 2000 m buffer, negatively affect health outcomes at all locations. For most locations, high PM2.5 or high floor area ratio with 2000 m buffer are linked to a high ratio of morbidity. Our findings support the use of such data for long-term urban and health planning. We expect our study to be a starting point for further research on spatially heterogeneous associations of the built environment with comprehensive health outcomes.

Keywords: Built environment; comprehensive health outcomes; multiscale geographically weighted regression; random forest approach; spatial heterogeneity.

MeSH terms

  • Built Environment*
  • China
  • Cities
  • Japan
  • Outcome Assessment, Health Care
  • Spatial Regression*