title: Age-adjusted mortality and its association to variations in urban conditions in Shanghai.
abstract: The objective of this study was to explore the association between health and urbanization in a megacity, Shanghai, by calculating the age-adjusted mortality ratio by ward-unit of Shanghai and by examining relationships between mortalities and urban indicators. Crude mortality rates and age-adjusted mortality ratios by ward-unit were calculated. Demographic, residential environment, healthcare, and socioeconomic indicators were formulated for each of the ward-units between 1995 and 1998. Correlation and Poisson regression analyses were performed to examine the association between urban indicators and mortalities. The crude mortality rate by ward-unit in 1997 varied from 6.3 to 9.4 deaths per 1000 population. The age-adjusted mortality ratio in 1997 by ward-units as reference to the average mortality of urban China varied from 57.8 to 113.3 within Shanghai. Age-adjusted mortalities were inversely related with indicators of a larger floor space of dwellings per population, a larger proportion of parks, gardens, and green areas to total land area; a greater number of health professionals per population; and a greater number of employees in retail business per population. Spacious living showed independent association to a higher standard of community health in Shanghai (P < 0.05). Consequences of health policy and the developments of urban infrastructural resources from the viewpoint of the Healthy Cities concept were discussed.
authors.affiliation: Health Promotion/International Health, Division of Public Health, Graduate School of Tokyo Medical and Dental University, Yushima 1-5-45, Bunkyo-ku, Tokyo 113-8519, Japan. takano.hlth@tmd.ac.jp
authors.forename: Takehito
authors.initials: T
authors.lastname: Takano
authors.forename: Jia
authors.initials: J
authors.lastname: Fu
authors.forename: Keiko
authors.initials: K
authors.lastname: Nakamura
authors.forename: Kazuyuki
authors.initials: K
authors.lastname: Uji
authors.forename: Yoshiharu
authors.initials: Y
authors.lastname: Fukuda
authors.forename: Masafumi
authors.initials: M
authors.lastname: Watanabe
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Nakajima
mesh_terms: D000367:Age Factors; D002391:Catchment Area, Health / Q000706:statistics & numerical data*; D002681:China / Q000453:epidemiology; D003430:Cross-Sectional Studies; D004779:Environment Design; D005843:Geography; D006291:Health Policy; D006305:Health Status Indicators; D006801:Humans; D009026:Mortality; D016012:Poisson Distribution; D012931:Social Environment; D014504:Urban Health