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SHR Neuro Cancer Cardio Lipid Metab Microb

Li, CC; Du, ZC; Fan, SJ; Mute, Browning, MHE; Knibbs, LD; Bloom, MS; Zhao, TY; Jalaludin, B; Heinrich, J; Liu, XX; Li, JX; Zhang, YD; Hu, LX; Xiang, MD; Chen, GB; Wang, Q; Han, CL; Li, SS; Guo, YM; Dadvand, P; Dong, GH; Zhang, ZB; Yang, BY.
Association between long-term green space exposure and mortality in China: A difference-in-differences analysis of national data in 2000, 2010 and 2019.
Sci Total Environ. 2023; 887: 164023 Doi: 10.1016/j.scitotenv.2023.164023
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Co-authors Med Uni Graz: Zhao Tianyu
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Abstract:: BACKGROUND: Effects of green space on human health have been well-documented in western, high-income countries. Evidence for similar effects in China is limited. Moreover, the underlying mechanisms linking green space and mortality are yet to be established. We therefore conducted a nation-wide study to assess the association between green space and mortality in China using a difference-in-difference approach, which applied a causal framework and well controlled unmeasured confounding. In addition, we explored whether air pollution and air temperature could mediate the association. METHODS: In this analysis, we collected data on all-cause mortality and sociodemographic characteristics for each county in China from the 2000 and 2010 censuses and the 2020 Statistical Yearbook. Green space exposure was assessed using county-level normalized difference vegetation index (NDVI) and the percentage of green space (forest, grasslands, shrub land and wetland). We applied a difference-in-differences approach to evaluate the association between green space and mortality. We also performed mediation analysis (by air pollution and air temperature). RESULTS: Our sample consisted of 2726 counties in 2000 and 2010 as well as 1432 counties in 2019. In the 2000 versus 2019 comparison, a 0.1 unit increase in NDVI was associated with a 2.4 % reduction in mortality [95 % confidence interval (CI) 0.4-4.3 %], and a 10 % increase in percentage of green space was associated with a 4.7 % reduction (95 % CI 0-9.2 %) in mortality. PM_2.5 and air temperature mediated 0.3 % to 12.3 % of the associations. CONCLUSIONS: Living in greener counties may be associated with lower risk of mortality in China. These findings could indicate the potential of a population-level intervention to reduce mortality in China, which has important public health implications at the county level.
Find related publications in this database (using NLM MeSH Indexing): Humans - administration & dosage; Parks, Recreational - administration & dosage; Air Pollution - analysis; China - administration & dosage; Income - administration & dosage; Forests - administration & dosage; Particulate Matter - analysis; Environmental Exposure - analysis; Air Pollutants - analysis