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. 2023 Sep;77(9):594-600.
doi: 10.1136/jech-2023-220681. Epub 2023 Jun 27.

Impact of built environment change on all-cause and cause-specific mortality: a novel longitudinal method and study

Laura Macdonald  1 , Natalie Nicholls  2 , Denise Brown  2 , Richard Mitchell  2
Affiliations

Impact of built environment change on all-cause and cause-specific mortality: a novel longitudinal method and study

Laura Macdonald et al. J Epidemiol Community Health. 2023 Sep.

Abstract

Background: Public health research increasingly acknowledges the influence of built environments (BE) on health; however, it is uncertain how BE change is associated with better population health and whether BE change can help narrow health inequalities. This knowledge gap is partly due to a lack of suitable longitudinal BE data in most countries. We devised a method to quantify BE change longitudinally and explored associations with mortality. The method is replicable in any nation that captures BE vector map data.

Methods: Ordnance Survey data were used to categorise small areas as having no change, loss or gain, in buildings, roads, and woodland between 2015 and 2019. We examined individual mortality records for 2012-2015 and 2016-2019, using negative binomial regression to explore associations between BE change and all-cause and cause-specific mortality, adjusting for income deprivation.

Results: BE change varied significantly by deprivation and urbanicity. Change in the BE and change in mortality were not related, however, areas that went on to experience BE change had different baseline mortality rates compared with those that did not. For example, areas that gained infrastructure already had lower mortality rates.

Conclusion: We provide new methodology to quantify BE change over time across a nation. Findings provide insight into the health of areas that do/do not experience change, prompting critical perspectives on cross-sectional studies of associations between BE and health. Methods and findings applied internationally could explore the context of BE change and its potential to improve health in areas most in need beyond the UK.

Keywords: GIS; Health inequalities; MORTALITY; PUBLIC HEALTH.

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Conflict of interest statement

Competing interests: None declared.

Figures

Figure 1
Figure 1
(A) Infrastructure increase, 2015–2019, in a Glasgow neighbourhood (Google Earth, 2023). (B) Woodland increase, 2015–2019, in a South Lanarkshire park (Google Earth, 2023).
Figure 2
Figure 2
Built environment change, 2015–2019, within data zones across Scotland (GCS OSGB 1936, Geographic Coordinate System Ordnance Survey Great Britain 1936)
See this image and copyright information in PMC

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