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The Equigenic Effect of Greenness on the Association between Education with Life Expectancy and Mortality in 28 Large Latin American Cities

38 Pages Posted: 14 Apr 2021

See all articles by Mika Ruchama Moran

Mika Ruchama Moran

University of California, Berkeley - Institute for Urban and Regional Development

Usama Bilal

Drexel University - Urban Health Collaborative

Iryna Dronova

University of California, Berkeley - Department of Landscape Architecture and Environmental Planning

Yang Ju

University of California, Berkeley - Institute for Urban and Regional Development

Nelson Gouveia

University of São Paulo (USP)

Waleska Teixeira Caiaffa

Federal University of Minas Gerais (UFMG) - Urban Health Observatory in Belo Horizonte

Amélia Augusta de Lima Friche

Federal University of Minas Gerais (UFMG) - Urban Health Observatory in Belo Horizonte

Kari Moore

Drexel University

J. Jaime Miranda

Universidad Peruana Cayetano Heredia

Daniel A. Rodriguez

University of California, Berkeley - Department of City and Regional Planning and Institute for Transportation Studies

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Abstract

Background: Recent studies highlight the equigenic potential of greenspaces by showing narrower socioeconomic health inequalities in greener areas. However, results to date have been inconsistent and derived from high-income countries. We examined whether urban greenness modifies the associations between area-level education, as a proxy for socioeconomic status, and life expectancy and cause-specific mortality in Latin American cities.

Methods: We included 28 large cities, >137 million inhabitants, in nine Latin American countries, comprising 671 sub-city units, for 2012–2016. Socioeconomic status was assessed through a composite index of sub-city level education, and greenness was calculated using the normalized difference vegetation index. We fitted multilevel models with sub-city units nested in cities, with life expectancy or log(mortality) as the outcome.

Findings: We observed a social gradient, with higher levels of education associated with higher life expectancy and lower cause-specific mortality. There was evidence of an interaction by greenness on the association between education and life expectancy (both sexes), cardiovascular diseases (CVD) mortality (in women), and violence-related mortality (in men). We observed an equigenic effect, with a narrower social gradient in greener areas, for violence-related mortality. Specifically, we found doubling magnitudes in the mortality reduction by education in areas with low greenness compared to medium-high greenness areas among men (16% [95% CI 0·80 to 0·88] vs 8% [95% CI 0·89 to 0·96] per 1 SD increase in area-level education). The equigenic effect was less pronounced in violence-related mortality among females and was not observed in the other outcomes.

Interpretation: Our results confirm socioeconomic health inequalities in Latin American cities and show that the equigenic properties of greenspace vary by health outcome.

Funding: Funding: Wellcome Trust (Grant 205177/Z/16/Z).

Declaration of Interest: None to declare.


Keywords: NDVI, Education, mortality, Latin America, urban health

Suggested Citation

Moran, Mika Ruchama and Bilal, Usama and Dronova, Iryna and Ju, Yang and Gouveia, Nelson and Caiaffa, Waleska Teixeira and de Lima Friche, Amélia Augusta and Moore, Kari and Miranda, J. Jaime and Rodriguez, Daniel A., The Equigenic Effect of Greenness on the Association between Education with Life Expectancy and Mortality in 28 Large Latin American Cities. Available at SSRN: https://ssrn.com/abstract=3826206 or http://dx.doi.org/10.2139/ssrn.3826206

Mika Ruchama Moran (Contact Author)

University of California, Berkeley - Institute for Urban and Regional Development ( email )

Berkeley, CA
United States

Usama Bilal

Drexel University - Urban Health Collaborative ( email )

Philadelphia, PA
United States

Iryna Dronova

University of California, Berkeley - Department of Landscape Architecture and Environmental Planning ( email )

310 Barrows Hall
Berkeley, CA 94720
United States

Yang Ju

University of California, Berkeley - Institute for Urban and Regional Development ( email )

310 Barrows Hall
Berkeley, CA 94720
United States

Nelson Gouveia

University of São Paulo (USP) ( email )

Av Dr Arnaldo, 455
São Paulo, São Paulo 01246-903
Brazil

Waleska Teixeira Caiaffa

Federal University of Minas Gerais (UFMG) - Urban Health Observatory in Belo Horizonte ( email )

Av. Antonio Carlos, 6627
Belo Horizonte, Minas Gerais 31270-901
Brazil

Amélia Augusta De Lima Friche

Federal University of Minas Gerais (UFMG) - Urban Health Observatory in Belo Horizonte ( email )

Av. Antonio Carlos, 6627
Belo Horizonte, Minas Gerais 31270-901
Brazil

Kari Moore

Drexel University

3141 Chestnut St
Philadelphia, PA 19104
United States

J. Jaime Miranda

Universidad Peruana Cayetano Heredia

Lima
Peru

Daniel A. Rodriguez

University of California, Berkeley - Department of City and Regional Planning and Institute for Transportation Studies ( email )

310 Barrows Hall
Berkeley, CA 94720
United States

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