Elsevier

Environment International

Volume 121, Part 1, December 2018, Pages 931-941
Environment International

Socioeconomic inequalities in urban and transport planning related exposures and mortality: A health impact assessment study for Bradford, UK

https://doi.org/10.1016/j.envint.2018.10.017Get rights and content
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Highlights

  • 10% of mortality in Bradford is attributable to breaching physical activity, air pollution, noise and green space guidelines.

  • Residents of lower socioeconomic position neighborhoods had the highest risks for adverse exposure and premature death.

  • Reduction of motor traffic, the promotion of active transport and greening of the district are recommended.

  • Interventions should focus on lower socioeconomic position neighborhoods as the largest health gains are expected there.

Abstract

Background

Cities have unique geographic, environmental and sociocultural characteristics that influence the health status of their citizens. Identification and modification of these characteristics may help to promote healthier cities.

Objective

We estimated premature mortality impacts of breaching international exposure guidelines for physical activity (PA), air pollution, noise and access to green space for Bradford (UK) adult residents (n = 393,091).

Methods

We applied the Urban and TranspOrt Planning Health Impact Assessment (UTOPHIA) methodology and estimated mortality, life expectancy (LE) and economic impacts of non-compliance with recommended exposure levels. We also investigated the distribution of the mortality burden among the population, focusing on socioeconomic position (SEP) as defined by deprivation status and ethnicity.

Results

We estimated that annually almost 10% of premature mortality (i.e. 375 deaths, 95% CI: 276–474) in Bradford is attributable to non-compliance with recommended exposure levels. Non-compliance was also estimated to result in over 300 days of LE lost (95% CI: 238–432), which translated in economic losses of over £50,000 per person (95% CI: 38,518–69,991). 90% of the premature mortality impact resulted from insufficient PA performance. Air and noise pollution and the lack of green space had smaller impacts (i.e. 48 deaths). Residents of lower SEP neighborhoods had the highest risks for adverse exposure and premature death. A larger number of deaths (i.e. 253 and 145, respectively) could be prevented by reducing air and noise pollution levels well below the guidelines.

Discussion

Current urban and transport planning related exposures result in a considerable health burden that is unequally distributed among the Bradford population. Improvements in urban and transport planning practices including the reduction of motor traffic and the promotion of active transport together with greening of the district, particularly in areas of lower SEP, are promising strategies to increase PA performance and reduce harmful environmental exposures.

Abbreviations

BiB
Born in Bradford cohort study
ERF
Exposure response function
ESCAPE
European Study of Cohorts for Air Pollution Effects
IMD
Index of Multiple Deprivation
LE
Life expectancy
LUR
Land use regression
LSOA
Lower Super Output Area
Lden
EU noise indicator with 5 and 10 dB penalties for the evening and night time, respectively
METs
Metabolic equivalents of tasks
NDVI
Normalized Difference Vegetation Index
NPPF
National Planning Policy Framework
NO2
Nitrogen dioxide
PA
Physical activity
PAF
Population attributable fraction
PM2.5
Particular matter with diameter ≤2.5 μm
RR
Relative risk
SEP
Socioeconomic position
UK
United Kingdom
UTOPHIA
Urban and TranspOrt Planning Health Impact Assessment methodology
VSLY
Value of a statistical life year
WHO
World Health Organization
%GS
Percentage green space

Keywords

Active transport
Deprivation
Ethnicity
Green space
Physical activity

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