Int J Health Geogr - Gaining a better understanding of respiratory health inequalities among cities: an ecological case study on elderly males in the larger French cities.

Tópicos

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Resumo

CKGROUND: In recent years, there have been a growing number of studies on spatial inequalities in health covering a variety of scales, from small areas to metropolitan areas or regions, and for various health outcomes. However, few investigations have compared health status between cities with a view to gaining a better understanding of the relationships between such inequalities and the social, economic and physical characteristics. This paper focuses on disparities in respiratory health among the 55 largest French cities. The aim is to explore the relationships between inter-urban health patterns, city characteristics and regional context, and to determine how far a city's health status relates to the features observed on different geographical scales.METHODS: We used health data describing hospitalizations for Chronic Obstructive Pulmonary Disease (COPD) as a proxy for respiratory health, and the total number of hospitalizations (overall) as a proxy for general health. This last indicator was used as a benchmark. A large set of indicators relating to socioeconomic, physical and amenity aspects of the cities (urban units) was also constructed. Data were analyzed using linear correlations and multiple linear regression models.RESULTS: The results suggest that socioeconomic characteristics are major discriminators for inequalities in respiratory health status among urban units. Indeed, once combined to socioeconomic characteristics, only a climate indicator remained significant among the physical indicators. It appeared that the pollution indicators which were significantly correlated with COPD hospitalization rates loosed significance when associated to the socio-economic indicators in a multiple regression. The analysis showed that among the socio-economic indicators, an employment indicator derived at the regional scale, and two indicators reflecting the unequal intra-urban spatial distribution of population according to their education, were the most efficient to describe differences in the respiratory health status of urban units.CONCLUSION: In order to design effective urban policies, it is essential to gain a better understanding of the differences among cities in their entirety, rather than solely differences across small urban areas or individuals.

Resumo Limpo

ckground recent year grow number studi spatial inequ health cover varieti scale small area metropolitan area region various health outcom howev investig compar health status citi view gain better understand relationship inequ social econom physic characterist paper focus dispar respiratori health among largest french citi aim explor relationship interurban health pattern citi characterist region context determin far citi health status relat featur observ differ geograph scalesmethod use health data describ hospit chronic obstruct pulmonari diseas copd proxi respiratori health total number hospit overal proxi general health last indic use benchmark larg set indic relat socioeconom physic amen aspect citi urban unit also construct data analyz use linear correl multipl linear regress modelsresult result suggest socioeconom characterist major discrimin inequ respiratori health status among urban unit inde combin socioeconom characterist climat indic remain signific among physic indic appear pollut indic signific correl copd hospit rate loos signific associ socioeconom indic multipl regress analysi show among socioeconom indic employ indic deriv region scale two indic reflect unequ intraurban spatial distribut popul accord educ effici describ differ respiratori health status urban unitsconclus order design effect urban polici essenti gain better understand differ among citi entireti rather sole differ across small urban area individu

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