Influence of residential land cover on hospitalizations: a population-based study

Abstract

Background: recent research showed that residential land cover may affect health outcomes in children; the influence on adult health status, however, still needs to be clarified.

Aim: to assess the influence of residential land cover on hospitalizations in a general population sample.

Methods: 2658 subjects (females: 55.0%; age range: 15-97) living in Pisa, Italy, were investigated in 1991-93 through a questionnaire on health status and risk factors. Hospitalizations for cardiovascular (CVD), cancer (CANC) and respiratory (RESP) diseases were followed-up until 2015. Land-cover exposures within a 1000 m buffer from each subjects’ home address were computed using data from the CORINE program (CLC 1990). The associations of hospitalizations (at least one from 1996 to 2015) with land coverage were estimated using multinomial logistic regression models adjusted for the main confounding factors (reference category: subjects alive and not hospitalized between 1996-2015).

Results: the following cumulative rates of CVD, CANC and RESP hospitalizations emerged: 41.6%, 25.5% and 19.8%. A 10% increase in agricultural space coverage was associated with lower risk of CVD (OR [95% CI]: 0.93 [0.89-0.98]) and RESP (OR 0.92 [0.87-0.97]) hospitalizations; vice versa, a 10% increase in grey and blue space coverage was associated with higher risk of CVD (OR 1.07 [1.02-1.12]; OR 1.69 [1.10-2.58], respectively), RESP (OR 1.08 [1.02-1.14]; OR 2.30 [1.41-3.76], respectively) and CANC (OR 1.73 [1.10-2.73], only for blue spaces) hospitalizations.

Conclusions: Living close to agricultural space may provide protective effects on health outcomes, while exposure to grey and blue (i.e. Arno river) spaces may have adverse effects.