Deciphering the stroke–built environment nexus in transitional cities: Conceptual framework, empirical evidence, and implications for proactive planning intervention

Bo Xie, Junfeng Jiao, Zihao An, Yiling Zheng, Zhigang Li

Research output: Contribution to journalArticle

1 Citation (Scopus)

Abstract

Adverse lifestyle-associated health outcomes, and stroke in particular, have been aggravated in transitional countries under high-speed urbanisation. Against this backdrop, deciphering the nexus between built environments (BEs) and lifestyle-associated health outcomes is of importance for crafting proactive interventions. The existing literature on this topic, however, fails to sufficiently capture the multiplicity of health-related BEs and, in turn, the complexity of such a nexus, largely challenging the applicability of established frameworks and the reliability of relevant findings. Looking at the case of stroke in Wuhan, China, this research aims to flesh out the understanding of the nexus between multidimensional BEs and lifestyle-associated health outcomes in transitional cities, with regards to conceptual framework and empirical evidence. To this end, we clarified stroke-related BE elements and integrated them into one conceptual framework. We then visualised stroke risk and examined its BE determinants using the Bayesian conditional autoregressive model. The visualisation results showed that stroke risks exhibited significant clustering in the high-density urban core. The statistical analysis found that, after the data were controlled for sociodemographic characteristics, net population density and building density were positively associated with stroke risk. In contrast, an abundance of public parks and institutional land use and access to medical care facilities have presented negative correlations with stroke risk, regardless of urban density. Our research reveals that compact urban developments might not be a silver bullet for health promotion in transitional cities, calling for an urgent need to scrutinise their applicability. To offset the adverse effects of increasingly dense urban environments, more efforts should also be made to provide better access to the identified salubrious resources. Furthermore, we argue that the establishment of comprehensive conceptual frameworks that connect BEs and lifestyle-associated health outcomes deserves to be highlighted in further research, planning intervention schemes, and health impact assessment projects.

Original languageEnglish (US)
Pages (from-to)116-128
Number of pages13
JournalCities
Volume94
DOIs
StatePublished - Nov 1 2019

Fingerprint

stroke
conceptual framework
planning
lifestyle
evidence
health
building density
health impact
population density
city
Empirical evidence
Conceptual framework
Planning
health promotion
urban development
medical care
statistical analysis
visualization
research planning
built environment

Keywords

  • Built environment
  • China
  • Lifestyle-associated health outcome
  • Stroke
  • Transitional city

ASJC Scopus subject areas

  • Development
  • Sociology and Political Science
  • Urban Studies
  • Tourism, Leisure and Hospitality Management

Cite this

Deciphering the stroke–built environment nexus in transitional cities : Conceptual framework, empirical evidence, and implications for proactive planning intervention. / Xie, Bo; Jiao, Junfeng; An, Zihao; Zheng, Yiling; Li, Zhigang.

In: Cities, Vol. 94, 01.11.2019, p. 116-128.

Research output: Contribution to journalArticle

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