建成环境健康影响研究的行为变量及其中介效应——以上海市社区老年人的健康行为为例

 建成环境对人群健康的影响具有暴露时间长、影响因素多、证据和结果难以测度等特点。为了在两者之间建立较为直观的关联，研究引入了健康行为作为中介变量以评估社区建成环境要素对老年人群健康的影响水平和调节方向。根据来自上海市115个社区的老年人（N=3431）的体质和心理健康状况，研究针对密度、设计、住房、绿地、公共设施与区位等建成环境要素的健康影响，构建了以体力活动和社会活动为中介变量的中介效应分析模型。研究表明，体力活动和社会活动是观测建成环境健康影响的有效中介变量，通过健康行为的中介效应可以更加清晰地揭示建成环境要素对人群健康的影响程度和影响方向。从实践的角度来看，基于不同建成环境的基底条件，健康行为的调节方向相似，但调节程度不同。对于以上海为代表的特大城市高密度人居环境而言，通过优化建成环境的品质促进社会活动对老年人的健康影响更为显著。

Behavioral variables and its mediating effects in the studies of the impact of the built environment on the health:Case study of the healthy behavior of the older residents in Shanghai communities

The impacts of the built environment on the public health might be difficult to be confirmed, as they are affected by a long exposure time, with various influencing factors, which are hard to be measured. In order to establish an intuitive correlation between the built environment and the public health, this study takes the healthy behavior as the mediator variable. According to the physical and mental health status of elderly people(N=3431) from 115 communities in Shanghai, we take 6 ranges of the built environment factors to construct a mediating effect analysis model with the physical activity and the social activity as the mediator variables. The built environment factors are the density, the design, the housing, the green space, the public facilities and the location. It is found that the physical activity and the social activity are effective mediators, and the mediating effects of the healthy behaviors are shown to more clearly reveal the extent and the direction of the impact of the built environment on the elders' health condition. Based on the practice, the behavioral variables' adjustment directions of the health outcome are similar, but the degree of the adjustment is different among the different neighborhoods. For the high-density human settlement in megacities represented by Shanghai, the optimization of the quality of the built environment for promoting the social activities has a more significant impact on the health of the elderly.