Ecological Study of Urban Built Environment and Hospital Admissions

Abstract

INTRODUCTION: This study examined the associations between the urban built environmental features and the number of hospital admissions for hypertension in Kuala Lumpur. METHODS: Disease specific records of hospital admissions from year 2008 to 2016 with individual patient’s socio demography and residential postcodes were collected from the Ministry of Health Malaysia. Urban built environmental features and land use data were acquired from the Planning Department of the Kuala Lumpur City Hall. The built environmental data were then subjected to kernel density computations in ArcMap at 400m, 800m, and 1200m for walkability metrics (rail stations, bus stops, road intersections, recreational areas and undeveloped land); and 250m, 500m and 1000m for environmental pollution metrics (roads, highways, rail tracks, and industrial areas). Other included variables are land use mix, residential densities, and economy. RESULTS: Quasi-poisson regressions indicated that increased densities of bus stops at the highest intensity were consistently associated with increased number of hospital admissions for hypertension for all regression models. Conversely, increased densities of undeveloped land were associated with reduced number of hospital admissions for hypertension. Results obtained for the environmental pollution metrics were inconsistent. Among the socio-demographic groups, consistent positive associations were found for the entropy index, and bus stops; and negative associations for residential densities, rail stations, and undeveloped land across all groups. CONCLUSION: Although this is an ecological study, the initial findings pose further questions on the appropriate urban planning that will fit the local conditions to benefit health in the developing countries especially in the Southeast Asian region.

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@proceedings{APCPH-2019-19,
title = {Ecological Study of Urban Built Environment and Hospital Admissions},
author = {Kwan Soo Chen and Rohaida Ismail and Norlen Mohamed and Nor Halizam Ismail},
year  = {2019},
date = {2019-07-22},
urldate = {2019-07-22},
journal = {6th Asia-Pacific Conference on Public Health 2019 Proceedings},
issue = {6},
abstract = {INTRODUCTION: This study examined the associations between the urban built environmental features and the number of hospital admissions for hypertension in Kuala Lumpur. METHODS: Disease specific records of hospital admissions from year 2008 to 2016 with individual patient’s socio demography and residential postcodes were collected from the Ministry of Health Malaysia. Urban built environmental features and land use data were acquired from the Planning Department of the Kuala Lumpur City Hall. The built environmental data were then subjected to kernel density computations in ArcMap at 400m, 800m, and 1200m for walkability metrics (rail stations, bus stops, road intersections, recreational areas and undeveloped land); and 250m, 500m and 1000m for environmental pollution metrics (roads, highways, rail tracks, and industrial areas). Other included variables are land use mix, residential densities, and economy. RESULTS: Quasi-poisson regressions indicated that increased densities of bus stops at the highest intensity were consistently associated with increased number of hospital admissions for hypertension for all regression models. Conversely, increased densities of undeveloped land were associated with reduced number of hospital admissions for hypertension. Results obtained for the environmental pollution metrics were inconsistent. Among the socio-demographic groups, consistent positive associations were found for the entropy index, and bus stops; and negative associations for residential densities, rail stations, and undeveloped land across all groups. CONCLUSION: Although this is an ecological study, the initial findings pose further questions on the appropriate urban planning that will fit the local conditions to benefit health in the developing countries especially in the Southeast Asian region.},
note = {Type: PLENARY AND SYMPOSIUM; Organisation: 1Center for Southeast Asian Studies (CSEAS), Kyoto University, Japan, 2Environmental Health Unit, Ministry of Health Malaysia, 3Health and Environment Department, Kuala Lumpur City Hall, Malaysia.},
keywords = {},
pubstate = {published},
tppubtype = {proceedings}
}