社区步行环境对中国居民死亡的影响及路径分析

doi:10.16352/j.issn.1001-6325.2025.12.1632

基础医学与临床 ›› 2025, Vol. 45 ›› Issue (12): 1632-1638.doi: 10.16352/j.issn.1001-6325.2025.12.1632

社区步行环境对中国居民死亡的影响及路径分析

陈梦鑫^1#, 李梦雅^1#, 张飞云^2#, 马海滨³, 游凯⁴, 胡泊¹, 李卫^1,5*

1.中国医学科学院北京协和医学院阜外医院国家心血管病中心国家心血管疾病临床医学研究中心,北京 102308;
2.巴彦淖尔市疾病预防控制中心,内蒙古巴彦淖尔 015000;
3.西宁市疾病预防控制中心,青海西宁 810007;
4.北京市顺义区疾病预防控制中心,北京 101300;
5.中国医学科学院阜外医院深圳医院临床研究中心,广东深圳 518038

收稿日期:2025-01-07 修回日期:2025-03-25 出版日期:2025-12-05 发布日期:2025-11-25
通讯作者: ^*liwei@mrbc-nccd.com
作者简介:^#对本文有相同贡献
基金资助:
国家心血管病中心自主课题(NCRC2020002);中国医学科学院阜外医院中央高水平医院临床科研业务项目(NCRC2023-GSP-GG-36);国家心血管疾病临床医学研究中心深圳自主课题(NCRCSZ-2023-012)

Influence of neighborhood environment walkability on mortality of Chinese residents and its pathway

CHEN Mengxin^1#, LI Mengya^1#, ZHANG Feiyun^2#, MA Haibin³, YOU Kai⁴, HU Bo¹, LI Wei^1,5*

1. Medical Research & Biometrics Center, National Clinical Research Center for Cardiovascular Diseases, Fuwai Hospital, National Center for Cardiovascular Diseases, CAMS & PUMC, Beijing 102308;
2. Bayannaoer City Centre for Disease Control and Prevention, Bayannaoer 015000;
3. Xining Center for Disease Control and Prevention, Xining 810007;
4. Shunyi District Center for Disease Control and Prevention, Beijing 101300;
5. Clinical Research Center, Shenzhen Hospital, Fuwai Hospital, Chinese Academy of Medical Sciences, Shenzhen 518038, China

Received:2025-01-07 Revised:2025-03-25 Online:2025-12-05 Published:2025-11-25
Contact: ^*liwei@mrbc-nccd.com

1. 附件材料.docx(34KB)

摘要/Abstract

摘要： 目的评估中国人群中自评社区步行环境与死亡的关系。方法中国前瞻性城乡流行病学研究(PURE-China)在2005~2009年间从中国12个省份招募了47 931名年龄在35~70岁之间的参与者,社区步行环境数据使用社区环境步行量表(NEWS)收集,高分表明社区步行环境较好。主要结局是全因死亡和心血管死亡,采用Cox脆弱模型来评估社区步行环境与结局之间的关联,以及中介效应探索其影响路径。结果分析了35 490名参与者,其中60%为女性,平均年龄及其标准差为51.5(9.6)岁,中位随访时间为11.7年。社区步行环境评分的升高与全因死亡风险降低相关,其中总分(HR=0.85;95% CI,0.80~0.89)、土地利用混合度(HR=0.84;95% CI,0.79~0.88)和犯罪安全(HR=0.84;95% CI,0.80~0.89)这3个指标最为明显。社区步行环境可通过生活行为方式影响长期健康结局。结论在中国人群中,良好的社区步行环境与全因死亡风险较低有关,可以用来支持政策制定者采取行动,减轻社区环境差对健康的不利影响。

关键词: 死亡, 社区步行环境, 中介分析, 队列研究, Cox脆弱模型

Abstract: Objective To evaluate the association between self-reported neighborhood walkability environments and mortality in China. Methods The Prospective Urban Rural Epidemiology study in China(PURE-China) recruited 47 931 participants aged 35-70 from 12 provinces in China between 2005 and 2009. Neighborhood environmental indicators were collected using the Neighborhood Environment Walkability Scale(NEWS) questionnaire,with higher scores indicating better walkable environments. The primary outcomes were all-cause mortality and cardiovascular mortality,using Cox fragile model to evaluate the association between community walkability and outcomes,as well as exploring mediating pathways. Results Of 35 490 participants included in this study,60% were female,with a mean(SD) age of 51.5(9.6) years. The median follow-up was 11.7 years. This study found an association between higher community walkability score and reduced risk of all-cause mortality,with the total score(HR=0.85; 95% CI,0.80-0.89),land-use mix(HR=0.84; 95% CI,0.79-0.88),and crime safety(HR=0.84; 95% CI,0.80-0.89) showing the most significant associations. NEWS can affect long-term adverse outcomes through lifestyle. Conclusions In the Chinese population,favorable community walkability is associated with lower all-cause mortality risk,which may support policymakers to take actions to mitigate the adverse effects of poor community environments on health.

Key words: mortality, neighborhood environment walkability, mediation analysis, cohort study, Cox frailty model

中图分类号:

R714.252

陈梦鑫, 李梦雅, 张飞云, 马海滨, 游凯, 胡泊, 李卫. 社区步行环境对中国居民死亡的影响及路径分析[J]. 基础医学与临床, 2025, 45(12): 1632-1638.

CHEN Mengxin, LI Mengya, ZHANG Feiyun, MA Haibin, YOU Kai, HU Bo, LI Wei. Influence of neighborhood environment walkability on mortality of Chinese residents and its pathway[J]. Basic & Clinical Medicine, 2025, 45(12): 1632-1638.

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社区步行环境对中国居民死亡的影响及路径分析

Influence of neighborhood environment walkability on mortality of Chinese residents and its pathway

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