The impact of social capital, land use, air pollution and noise on individual morbidity in Dutch neighbourhoods. (December 2018)

• Record Type: Journal Article
• Authors: Zock, Jan-Paul; Verheij, Robert; Helbich, Marco; Volker, Beate; Spreeuwenberg, Peter; Strak, Maciek; Janssen, Nicole A.H.; Dijst, Martin; Groenewegen, Peter
• Is Part Of: Environment international. Volume 121(2018)Part 1
• Page Start: 453
• Page End: 460
• Publication Date: 2018-12
• Subjects: BAG base registrations addresses and buildings -- EHR electronic health record -- ESCAPE European study of cohorts for air pollution effects -- GP general practitioner -- LGN national land use Netherlands -- PM particulate matter -- IQR inter quartile range -- LDEN level day-evening-night -- MUPS medically unexplained physical symptoms -- NIVEL Netherlands Institute for Health Services Research -- OR odds ratio -- PC5 five-digit postal code -- PCD primary care database -- rs Spearman's correlation coefficient -- SSND study on the social networks of the Dutch; Greenspace -- Land use -- Neighbourhood -- Health -- Social capital -- Epidemiology; Environmental protection -- Periodicals; Environmental health -- Periodicals; Environmental monitoring -- Periodicals; Environmental Monitoring -- Periodicals; Environnement -- Protection -- Périodiques; Hygiène du milieu -- Périodiques; Environnement -- Surveillance -- Périodiques; Environmental health; Environmental monitoring; Environmental protection; Periodicals; 333.705
• DOI: 10.1016/j.envint.2018.09.008
• Languages: English
• ISSNs: 0160-4120

Abstract

Abstract: Background: Both social and physical neighbourhood factors may affect residents' health, but few studies have considered the combination of several exposures in relation to individual health status. Aim: To assess a range of different potentially relevant physical and social environmental characteristics in a sample of small neighbourhoods in the Netherlands, to study their mutual correlations and to explore associations with morbidity of residents using routinely collected general practitioners' (GPs') data. Methods: For 135 neighbourhoods in 43 Dutch municipalities, we could assess area-level social cohesion and collective efficacy using external questionnaire data, urbanisation, amount of greenspace and water areas, land use diversity, air pollution (particulate matter (PM) with a diameter <10 μm (PM10 ), PM <2.5 μm (PM2.5 ) and nitrogen dioxide (NO2 ), and noise (from road traffic and from railways). Health data of the year 2013 from GPs were available for 4450 residents living in these 135 neighbourhoods, that were representative for the entire country. Morbidity of 10 relevant physical or mental health groupings was considered. Individual-level socio-economic information was obtained from Statistics Netherlands. Associations between neighbourhood exposures and individual morbidity were quantified using multilevel mixed effects logistic regression analyses, adjusted for sex, age (continuous), household income and socio-economic status (individual level) and municipality and neighbourhood (group level). Results: Most physical exposures were strongly correlated with degree of urbanisation. Social cohesion and collective efficacy tended to be higher in less urbanised municipalities. Degree of urbanisation was associated with higher morbidity of all disease groupings. A higher social cohesion at the municipal level coincided with a lower prevalence of depression, migraine/severe headache and Medically Unexplained Physical Symptoms (MUPS). An increase in both natural and agricultural greenspace in the neighbourhood was weakly associated with less morbidity for all conditions. A high land use diversity was consistently associated with lower morbidities, in particular among non-occupationally active individuals. Conclusion: A high diversity in land use of neighbourhoods may be beneficial for physical and mental health of the inhabitants. If confirmed, this may be incorporated into urban planning, in particular regarding the diversity of greenspace. Highlights: Less crowded neighbourhoods have both social and environmental benefits. Greenspace near the home may be beneficial for physical and mental health. A diverse land use in the neighbourhood may have health benefits for the residents.