Multiple pathways and mediation effects of built environment on kidney disease rate via mitigation of atmospheric threats

• Published in: The Science of the total environment Vol. 833; p. 155177
• Main Author: Shen, Yu-Sheng
• Format: Journal Article
• Language: English
• Published: Netherlands Elsevier B.V 10-08-2022
• Subjects: Health adaptation; Particulate matter; Renal morbidity; Sustainable development; Urban environment; Urban health; Urban environment; Renal morbidity; Health adaptation; Sustainable development; Particulate matter; Urban health
• ISSN: 0048-9697; 1879-1026
• DOI: 10.1016/j.scitotenv.2022.155177

Air pollution and high temperatures can increase kidney disease rate, especially under climate change. A well-designed urban environment has mediating effects on atmospheric environmental threats and promoting human health, but previous studies have overlooked these effects. This study used partial least squares modeling and urban-scale data from Taiwan to identify the crucial effects (i.e., direct, indirect, and total effects) and pathways of urban form (i.e., urban development intensity, land-use mix, and urban sprawl), urban greening (i.e., green coverage), urban industrial status (e.g., industrial level), atmospheric environment (i.e., high temperature and air pollution), and socioeconomic status (i.e., elderly ratio, medical resources, and economic status) on kidney disease rate. Maximizing land-use mix and green coverage and minimizing urban development intensity, urban sprawl, and industrial levels could help reduce kidney disease rate. Air pollution and high temperature had a mediation effect of built environment on kidney disease rate; with the mediation effect of air pollution was greater than that of high temperature. Furthermore, air pollution, high temperature, and elderly ratio increased kidney disease rate, whereas medical resources decreased kidney disease rate. This study is the first to consider the impact (i.e., direct, indirect, and total effects) and pathways of built environment characteristics on kidney disease rate. The findings revealed that an appropriate urban policy might be a practical strategy and lower kidney disease rate for a healthy city development. Moreover, this study provides a new approach for clarifying complex relationships and identifying crucial factors.
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•Appropriate land-use mix and green coverage could lower kidney disease rate.•Minimizing urban sprawl and urban intensity could lower kidney disease rate.•Kidney disease rate could be mediated by urban form characteristics.•High temperature and air pollution simultaneously affect kidney disease rate.•Industrial level and socioeconomic status are crucial for kidney disease rate.