Last defense in climate change: Assessing healthcare inequities in response to compound environmental risk in a megacity in Northern China

IF 10.5 1区工程技术 Q1 CONSTRUCTION & BUILDING TECHNOLOGY

Sustainable Cities and Society Pub Date : 2024-10-09 DOI:10.1016/j.scs.2024.105886

Qi Cheng , Shiyan Sha

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Abstract

The compound risk of extreme heat and air pollution in the context of climate change has become an important challenge for megacities in Northern China. Severe spatial differences exist in healthcare facilities, which are the last defense to protect the health of residents. Understanding the match between compound risks and healthcare services is important for ensuring the basic well-being of residents. We selected 255 census units in Tianjin to comprehensively assess the healthcare services and risks of hazards, exposures, and social vulnerabilities in order to explore the match between risks and services. We quantified and graded environmental quality on a 5-point scale and investigated inequalities in risk-service relationships across different regions using correlation analysis, analysis of variance (ANOVA), and LISA. The results showed that: (1) the level of compound risk and the variability of risk increased with environmental degradation, main urban areas exhibited the highest level of risk, while suburban and district centralized construction areas demonstrated significant variability in risk; (2) the relationship was significantly imbalanced between healthcare services and risk in suburban and peripheral districts and counties, while the main urban areas and rural areas showed high and low levels of matching respectively; and (3) blue-green spaces could effectively alleviate the pressure on healthcare services in the main urban area and rural area. The results obtained in this study provide references for healthcare allocation strategies in areas with different degrees of environmental degradation, and we call for further planning of healthcare facilities in megacities to enhance their ability to adapt to climate change risks.

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气候变化中的最后一道防线：评估华北某特大城市在应对复合环境风险时的医疗保健不平等现象

在气候变化的背景下，极端高温和空气污染的复合风险已成为中国北方特大城市面临的重要挑战。作为保护居民健康的最后一道防线，医疗卫生设施存在着严重的空间差异。了解复合风险与医疗服务之间的匹配关系对于确保居民的基本福祉非常重要。我们选取了天津市的 255 个普查单位，全面评估了医疗卫生服务与危害风险、暴露风险和社会脆弱性，以探索风险与服务之间的匹配关系。我们以 5 分制对环境质量进行了量化和分级，并采用相关分析、方差分析（ANOVA）和 LISA 等方法研究了不同地区风险与服务关系的不平等性。结果显示(1）复合风险水平和风险变异性随环境退化而增加，主城区风险水平最高，而郊区和区县集中建设区风险变异性显著；（2）郊区和周边区县医疗卫生服务与风险关系显著失衡，而主城区和农村地区分别表现为高匹配和低匹配；（3）蓝绿空间可有效缓解主城区和农村地区的医疗卫生服务压力。本研究的结果为不同环境退化程度地区的医疗资源配置策略提供了参考，我们呼吁进一步规划特大城市的医疗设施，以提高其适应气候变化风险的能力。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Sustainable Cities and Society Social Sciences-Geography, Planning and Development

CiteScore

22.00

自引率

13.70%

发文量

810

审稿时长

27 days

期刊介绍： Sustainable Cities and Society (SCS) is an international journal that focuses on fundamental and applied research to promote environmentally sustainable and socially resilient cities. The journal welcomes cross-cutting, multi-disciplinary research in various areas, including: 1. Smart cities and resilient environments; 2. Alternative/clean energy sources, energy distribution, distributed energy generation, and energy demand reduction/management; 3. Monitoring and improving air quality in built environment and cities (e.g., healthy built environment and air quality management); 4. Energy efficient, low/zero carbon, and green buildings/communities; 5. Climate change mitigation and adaptation in urban environments; 6. Green infrastructure and BMPs; 7. Environmental Footprint accounting and management; 8. Urban agriculture and forestry; 9. ICT, smart grid and intelligent infrastructure; 10. Urban design/planning, regulations, legislation, certification, economics, and policy; 11. Social aspects, impacts and resiliency of cities; 12. Behavior monitoring, analysis and change within urban communities; 13. Health monitoring and improvement; 14. Nexus issues related to sustainable cities and societies; 15. Smart city governance; 16. Decision Support Systems for trade-off and uncertainty analysis for improved management of cities and society; 17. Big data, machine learning, and artificial intelligence applications and case studies; 18. Critical infrastructure protection, including security, privacy, forensics, and reliability issues of cyber-physical systems. 19. Water footprint reduction and urban water distribution, harvesting, treatment, reuse and management; 20. Waste reduction and recycling; 21. Wastewater collection, treatment and recycling; 22. Smart, clean and healthy transportation systems and infrastructure;