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

MacDonald, L. , Nicholls, N. , Brown, D. and Mitchell, R. (2023) The impact of built environment change on all-cause and cause specific mortality: a novel longitudinal method and study. Journal of Epidemiology and Community Health, 77(9), pp. 594-600. (doi: 10.1136/jech-2023-220681) (PMID:37369593) (PMCID:PMC10423518)

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.

• Item Type: Articles
• Additional Information: This work was supported by the Medical Research Council (grant numbers: MC_UU_00022/4, MC_UU_00022/2) and Chief Scientist Office (grant numbers: SPHSU19, SPHSU17).
• Status: Published
• Refereed: Yes
• Glasgow Author(s) Enlighten ID: Brown, Dr Denise and Mitchell, Professor Rich and Nicholls, Dr Natalie and MacDonald, Mrs Laura
• Authors: MacDonald, L., Nicholls, N., Brown, D., and Mitchell, R.
• College/School: College of Medical Veterinary and Life Sciences > School of Health & Wellbeing > MRC/CSO SPHSU
• Journal Name: Journal of Epidemiology and Community Health
• Publisher: BMJ Publishing Group
• ISSN: 0143-005X
• ISSN (Online): 1470-2738
• Published Online: 27 June 2023
• Copyright Holders: Copyright © Author(s) (or their employer(s)) 2023
• First Published: First published in Journal of Epidemiology and Community Health 77(9):594-600
• Publisher Policy: Reproduced under a Creative Commons license

Project Code	Award No	Project Name	Principal Investigator	Funder's Name	Funder Ref	Lead Dept
304823007	1	Inequalities in health	Alastair Leyland	Office of the Chief Scientific Adviser (CSO)	SPHSU17	HW - MRC/CSO Social and Public Health Sciences Unit
304823009	1	Places and health	Rich Mitchell	Office of the Chief Scientific Adviser (CSO)	SPHSU19	HW - MRC/CSO Social and Public Health Sciences Unit
304823002	1	Inequalities in health	Alastair Leyland	Medical Research Council (MRC)	MC_UU_00022/2	HW - MRC/CSO Social and Public Health Sciences Unit
304823004	1	Places and health	Rich Mitchell	Medical Research Council (MRC)	MC_UU_00022/4	HW - MRC/CSO Social and Public Health Sciences Unit