Spatial association between green space and COPD mortality: a township-level ecological study in Chongqing, China

• Published in: BMC pulmonary medicine 2023-03, Vol.23 (1), p.89-11, Article 89
• Main Authors: Gou, Aiping, Tan, Guanzheng, Ding, Xianbin, Wang, Jiangbo, Jiao, Yan, Gou, Chunyan, Tan, Qiang
• Format: Article
• Language: English
• Subjects: Air pollution; Artificial satellites in remote sensing; Asthma; Care and treatment; China; China - epidemiology; Chongqing; Chronic illnesses; Chronic obstructive pulmonary disease; COPD; Correlation analysis; Cross-sectional studies; Diagnosis; Disease; Ecological studies; Environmental aspects; GAMs; Green space; GWR; Health aspects; Hospitals; Humans; Lung diseases; Lung diseases, Obstructive; Maximum likelihood method; Methods; Mortality; Obstructive lung disease; Outdoor air quality; Parks, Recreational; Public health; Pulmonary Disease, Chronic Obstructive; Pulmonology; Regression analysis; Remote sensing; Risk Factors; Spatial analysis (Statistics); Spatial distribution; Statistical analysis; Variables; Vegetation; Vegetation zones; VOCs; Volatile organic compounds; Water area
• ISSN: 1471-2466; 1471-2466
• DOI: 10.1186/s12890-023-02359-x

There are regional differences in the effect of green space on mortality of Chronic obstructive pulmonary disease (COPD). We conduct an ecological study, using the administrative divisions of Chongqing townships in China as the basic unit, to investigate the association between COPD mortality and green space based on data of 313,013 COPD deaths in Chongqing from 2012 to 2020. Green space is defined by Fractional vegetation cover (FVC), which is further calculated based on the normalised vegetation index (NDVI) from satellite remote sensing imagery maps. After processing the data, the non-linear relationship between green space and COPD mortality is revealed by generalised additive models; the spatial differences between green space and COPD mortality is described by geographically weighted regression models; and finally, the interpretive power and interaction of each factor on the spatial distribution of COPD mortality is examined by a geographic probe. The results show that the FVC local regression coefficients ranged from - 0.0397 to 0.0478, 63.0% of the regions in Chongqing have a positive correlation between green space and COPD mortality while 37.0% of the regions mainly in the northeast and west have a negative correlation. The interpretive power of the FVC factor on the spatial distribution of COPD mortality is 0.08. Green space may be a potential risk factor for increased COPD mortality in some regions of Chongqing. This study is the first to reveal the relationship between COPD mortality and green space in Chongqing at the township scale, providing a basis for public health policy formulation in Chongqing.