[en] Promoting health equity is key to achieving sustainable urban development. The National Sanitary Cities in China (NSCC) policy is a critical development model aimed at improving urban environments and enhancing public health. This study evaluates the selection criteria and policy impact of NSCCs, using the nearest neighbour index, geographic concentration index, imbalance index, and kernel density estimation to analyze their distribution characteristics. Additionally, it explores influencing factors using a geodetector model and spatial overlay analysis. The findings indicate a shift in NSCC selection criteria from urban sanitation to urban health, reflecting China’s strategic focus on achieving health equity. The spatial distribution analysis indicates that NSCCs exhibit a clustered pattern, characterized by dual cores, dual centres, multiple scattered points, and regional extensions. NSCCs are influenced by both natural and socioeconomic factors, with economy and population, technological innovation, and informatization exerting greater influences. This study is valuable for understanding the spatial patterns of NSCCs, providing a scientific basis for promoting equitable and sustainable health resource allocation and policymaking.
Disciplines :
Arts & humanities: Multidisciplinary, general & others
Author, co-author :
Deng, Yujia; College of Landscape Architecture, Sichuan Agricultural University, Chengdu 611130, China
Feng, Lixia; School of Emergency Science, Xihua University, Chengdu 610039, China
CENCI, Jeremy ; Université de Mons - UMONS > Faculté d'Architecture et d'Urbanisme > Service des Projets, Ville et Territoire
ZHANG, Jiazhen ; Université de Mons - UMONS > Faculté d'Architecture et d'Urbanisme > Service des Projets, Ville et Territoire ; Wales College, Lanzhou University, Lanzhou 730000, China
Cai, Jun; College of Landscape Architecture, Sichuan Agricultural University, Chengdu 611130, China
Language :
English
Title :
Analysis of Spatial and Driving Factors of National Sanitary Resources in China Using GIS
Kundu D. Pandey A.K. World Urbanisation: Trends and Patterns Developing National Urban Policies: Ways Forward to Green and Smart Cities Kundu D. Sietchiping R. Kinyanjui M. Springer Nature Singapore 2020 13 49 978-981-15-3738-7
Singh N. Singh S. Mall R.K. Chapter 17–Urban Ecology and Human Health: Implications of Urban Heat Island, Air Pollution and Climate Change Nexus Urban Ecology Verma P. Singh P. Singh R. Raghubanshi A.S. Elsevier Amsterdam, The Netherlands 2020 317 334 978-0-12-820730-7
Chaudhry D. Climate Change and Health of the Urban Poor: The Role of Environmental Justice J. Clim. Change Health 2024 15 100277 10.1016/j.joclim.2023.100277
Mouratidis K. Urban Planning and Quality of Life: A Review of Pathways Linking the Built Environment to Subjective Well-Being Cities 2021 115 103229 10.1016/j.cities.2021.103229
McGreevy M. Harris P. Delaney-Crowe T. Fisher M. Sainsbury P. Riley E. Baum F. How Well Do Australian Government Urban Planning Policies Respond to the Social Determinants of Health and Health Equity? Land Use Policy 2020 99 105053 10.1016/j.landusepol.2020.105053
Li X. Song J. Lin T. Dixon J. Zhang G. Ye H. Urbanization and Health in China, Thinking at the National, Local and Individual Levels Environ. Health 2016 15 113 123 10.1186/s12940-016-0104-5 26961780
Du P. Sun B. Pan L.J. Cheng Y.B. Li T.T. Wang X.L. Shi L.W. Yao X.Y. Shi X.M. Achievements and Prospects on Environmental Health and Sanitary Engineering in China Zhonghua Yu Fang Yi Xue Za Zhi Chin. J. Prev. Med. 2019 53 865 870 10.3760/cma.j.issn.0253-9624.2019.09.001
Li Y. Yang H. The Incentive Effect of Creating a National Health City on the Ecological Welfare Performance: Based on the Evidence of Yangtze River Delta in China Environ. Sci. Pollut. Res. 2023 30 83735 83759 10.1007/s11356-023-28207-3
Yin S. Chen W.Y. Liu C. Urban Forests as a Strategy for Transforming towards Healthy Cities Urban. For. Urban. Green. 2023 81 127871 10.1016/j.ufug.2023.127871
Palutturi S. Saleh L.M. Rachmat M. Malek J.A. Nam E.W. Principles and Strategies for Aisles Communities Empowerment in Creating Makassar Healthy City, Indonesia Gac. Sanit. 2021 35 S46 S48 10.1016/j.gaceta.2020.12.013
Bafarasat A. Cheshmehzangi A. Ankowska A. A Set of 99 Healthy City Indicators for Application in Urban Planning and Design Sustain. Dev. 2023 31 1978 1989 10.1002/sd.2499
Zhao M. Qin W. Zhang S. Qi F. Li X. Lan X. Assessing the Construction of a Healthy City in China: A Conceptual Framework and Evaluation Index System Public Health 2023 220 88 95 10.1016/j.puhe.2023.04.020
Ali M. Rahaman M. Hossain S. Urban Green Spaces for Elderly Human Health: A Planning Model for Healthy City Living Land Use Policy 2022 114 105970 10.1016/j.landusepol.2021.105970
Capolongo S. Rebecchi A. Dettori M. Appolloni L. Azara A. Buffoli M. Capasso L. Casuccio A. Conti G. D’Amico A. et al. Healthy Design and Urban Planning Strategies, Actions, and Policy to Achieve Salutogenic Cities Int. J. Environ. Res. Public Health 2018 15 2698 10.3390/ijerph15122698
Xie Y. Meng X. Cenci J. Zhang J. Spatial Pattern and Formation Mechanism of Rural Tourism Resources in China: Evidence from 1470 National Leisure Villages ISPRS Int. J. Geo-Inf. 2022 11 455 10.3390/ijgi11080455
Zhang Z. Cenci J. Zhang J. Policies for Equity in Access to Urban Green Space: A Spatial Perspective of the Chinese National Forest City Policy Forests 2024 15 608 10.3390/f15040608
Tao W. Zeng Z. Dang H. Li P. Chuong L. Yue D. Wen J. Zhao R. Li W. Kominski G. Towards Universal Health Coverage: Achievements and Challenges of 10 Years of Healthcare Reform in China BMJ Glob. Health 2020 5 e002087 10.1136/bmjgh-2019-002087 32257401
Chen J. Lin Z. Li L. Li J. Wang Y. Pan Y. Yang J. Xu C. Zeng X. Xie X. et al. Ten Years of China’s New Healthcare Reform: A Longitudinal Study on Changes in Health Resources BMC Public Health 2021 21 2272 10.1186/s12889-021-12248-9 34903184
Fu H. Dai J. Gao J. Jia Y. Zheng P. Healthy City Construction in China: Accomplishments and Prospects Chin. J. Public Health 2019 35 1285 1288 10.11847/zgggws1126106
Liu S.R. Wang H. Xi T.Y. Administrative Bidding, Performance, and Political Incentives——Evidence from National Health Cities J. Public Manag. 2020 17 10 20 10.16149/j.cnki.23-1523.20200804.002
Bai Y. Zhang Y. Zotova O. Pineo H. Siri J. Liang L. Luo X. Kwan M.-P. Ji J. Jiang X. et al. Healthy Cities Initiative in China: Progress, Challenges, and the Way Forward Lancet Reg. Health West. Pac. 2022 27 100539 10.1016/j.lanwpc.2022.100539
Announcement of the 2021 National Sanitary City and Town Reassessment Results by the National Patriotic Health Campaign Committee Available online: http://www.nhc.gov.cn/guihuaxxs/gongwen1/202202/253a2c03dbee4cf9a952238236fda163.shtml (accessed on 7 August 2024)
Zheng W. Yao H. Yu S. Liu J. Hu Y. Wang J. Residents’ Sense of Acquisition and Influencing Factors in China’s Sanitary City Initiative Chin. J. Epidemiol. 2023 44 457 462 10.3760/cma.j.cn112338-20220826-00739
Wang Y. Pei R. Gu X. Liu B. Liu L. Has the Healthy City Pilot Policy Improved Urban Health Development Performance in China? Evidence from a Quasi-Natural Experiment Sustain. Cities Soc. 2023 88 104268 10.1016/j.scs.2022.104268
Tang G. Lin M. Xu Y. Li J. Chen L. Impact of Rating and Praise Campaigns on Local Government Environmental Governance Efficiency: Evidence from the Campaign of Establishment of National Sanitary Cities in China PLoS ONE 2021 16 e0253703 10.1371/journal.pone.0253703
Yue D. Ruan S. Xu J. Zhu W. Zhang L. Cheng G. Meng Q. Impact of the China Healthy Cities Initiative on Urban Environment J. Urban Health 2017 94 149 157 10.1007/s11524-016-0106-1 28032240
Gan T. Zhang C. Shen R. Li B. Can the Establishment of National Sanitary Cities Better Resist the Impact of COVID-19? Front. Public Health 2023 11 1041355 10.3389/fpubh.2023.1041355
Zhou M. Wang H. Zeng X. Yin P. Zhu J. Chen W. Li X. Wang L. Wang L. Liu Y. et al. Mortality, Morbidity, and Risk Factors in China and Its Provinces, 1990–2017: A Systematic Analysis for the Global Burden of Disease Study 2017 Lancet 2019 394 1145 1158 10.1016/S0140-6736(19)30427-1 31248666
Barber R.M. Fullman N. Sorensen R.J.D. Bollyky T. McKee M. Nolte E. Abajobir A.A. Abate K.H. Abbafati C. Abbas K.M. et al. Healthcare Access and Quality Index Based on Mortality from Causes Amenable to Personal Health Care in 195 Countries and Territories, 1990–2015: A Novel Analysis from the Global Burden of Disease Study 2015 Lancet 2017 390 231 266 10.1016/S0140-6736(17)30818-8
The 2023 Statistical Bulletin on the Development of China’s Health Sector Available online: https://www.gov.cn/lianbo/bumen/202408/content_6971241.htm (accessed on 4 September 2024)
Yang G. What Is Historical Political Science? Chin. Political Sci. Rev. 2022 7 1 28 10.1007/s41111-021-00204-2
Feng D. Bao W. Yang Y. Fu M. How Do Government Policies Promote Greening? Evidence from China Land Use Policy 2021 104 105389 10.1016/j.landusepol.2021.105389
Ding A. Cenci J. Zhang J. Links between the Pandemic and Urban Green Spaces, a Perspective on Spatial Indices of Landscape Garden Cities in China Sustain. Cities Soc. 2022 85 104046 10.1016/j.scs.2022.104046
Dumais G. Ellison G. Glaeser E.L. Geographic Concentration as a Dynamic Process Rev. Econ. Stat. 2002 84 193 204 10.1162/003465302317411479
Zhang J. Cenci J. Becue V. Koutra S. Research of the Industrial Heritage Category and Spatial Density Distribution in Walloon Region and Northeast China WIT Trans. Built Environ. 2021 203 285 10.2495/STR210241
Wang X. Zhang J. Cenci J. Becue V. Spatial Distribution Characteristics and Influencing Factors of the World Architectural Heritage Heritage 2021 4 2942 2959 10.3390/heritage4040164
Song Y. Wang J. Ge Y. Xu C. An Optimal Parameters-Based Geographical Detector Model Enhances Geographic Characteristics of Explanatory Variables for Spatial Heterogeneity Analysis: Cases with Different Types of Spatial Data GI Sci. Remote Sens. 2020 57 593 610 10.1080/15481603.2020.1760434
Yang Y. Zhang L. Zhang X. Yang M. Zou W. Efficiency Measurement and Spatial Spillover Effect of Provincial Health Systems in China: Based on the Two-Stage Network DEA Model Front. Public Health 2022 10 952975 10.3389/fpubh.2022.952975
Wang K. Zhang Q. Zhang J. Analysis on Spatial Differences and Changes of Health Level in China Adv. Appl. Math. 2022 11 7524 7532 10.12677/AAM.2022.1111797
Ziafati Bafarasat A. Sharifi A. How to Achieve a Healthy City: A Scoping Review with Ten City Examples J. Urban Health 2024 101 120 140 10.1007/s11524-023-00798-9
Xie S. Yin G. Wei W. Sun Q. Zhang Z. Spatial–Temporal Change in Paddy Field and Dryland in Different Topographic Gradients: A Case Study of China during 1990–2020 Land 2022 11 1851 10.3390/land11101851
Wang X.-C. Klemeš J.J. Dong X. Fan W. Xu Z. Wang Y. Varbanov P.S. Air Pollution Terrain Nexus: A Review Considering Energy Generation and Consumption Renew. Sustain. Energy Rev. 2019 105 71 85 10.1016/j.rser.2019.01.049
Xi C. Qian T. Chi Y. Chen J. Wang J. Relationship between Settlements and Topographical Factors: An Example from Sichuan Province, China J. Mt. Sci. 2018 15 2043 2054 10.1007/s11629-018-4863-z
Chen R. Yin P. Wang L. Liu C. Niu Y. Wang W. Jiang Y. Liu Y. Liu J. Qi J. et al. Association between Ambient Temperature and Mortality Risk and Burden: Time Series Study in 272 Main Chinese Cities BMJ 2018 363 k4306 10.1136/bmj.k4306
Yao N. Li Y. Lei T. Peng L. Drought Evolution, Severity and Trends in Mainland China over 1961–2013 Sci. Total Environ. 2018 616–617 73 89 10.1016/j.scitotenv.2017.10.327 29107781
Liu J. Liu T. Burkart K.G. Wang H. He G. Hu J. Xiao J. Yin P. Wang L. Liang X. et al. Mortality Burden Attributable to High and Low Ambient Temperatures in China and Its Provinces: Results from the Global Burden of Disease Study 2019 Lancet Reg. Health West. Pac. 2022 24 100493 10.1016/j.lanwpc.2022.100493 35756888
Gao W. A Case Study of the Relationship Between Vegetation Coverage and Urban Heat Island in a Coastal City by Applying Digital Twins Front. Plant Sci. 2022 13 861768
Zhou M. Huang Y. Li G. Changes in the Concentration of Air Pollutants before and after the COVID-19 Blockade Period and Their Correlation with Vegetation Coverage Environ. Sci. Pollut. Res. 2021 28 23405 23419 10.1007/s11356-020-12164-2 33447974
Crane M. Lloyd S. Haines A. Ding D. Hutchinson E. Belesova K. Davies M. Osrin D. Zimmermann N. Capon A. et al. Transforming Cities for Sustainability: A Health Perspective Environ. Int. 2021 147 106366 10.1016/j.envint.2020.106366
Johnston B.M. Burke S. Kavanagh P.M. O’Sullivan C. Thomas S. Parker S. Moving beyond Formulae: A Review of International Population-Based Resource Allocation Policy and Implications for Ireland in an Era of Healthcare Reform HRB Open Res. 2021 4 121 10.12688/hrbopenres.13453.1
Marmot M. Health Equity in England: The Marmot Review 10 Years On BMJ 2020 368 m693 10.1136/bmj.m693
Bellini P. Nesi P. Pantaleo G. IoT-Enabled Smart Cities: A Review of Concepts, Frameworks and Key Technologies Appl. Sci. 2022 12 1607 10.3390/app12031607
Wan S. Chen Y. Xiao Y. Zhao Q. Li M. Wu S. Spatial Analysis and Evaluation of Medical Resource Allocation in China Based on Geographic Big Data BMC Health Serv. Res. 2021 21 1084 10.1186/s12913-021-07119-3
You H. Wu X. Guo X. Distribution of COVID-19 Morbidity Rate in Association with Social and Economic Factors in Wuhan, China: Implications for Urban Development Int. J. Environ. Res. Public Health 2020 17 3417 10.3390/ijerph17103417
Smith S.A. Mays G.P. Felix H.C. Tilford J.M. Curran G.M. Preston M.A. Impact of Economic Constraints on Public Health Delivery Systems Structures Am. J. Public Health 2015 105 e48 e53 10.2105/AJPH.2015.302769 26180988
Ma X. Bai Y. Zhang Z. Spatial Matching Analysis of Urban Health Resources and Population Distribution--A Case Study of the Central District of Lanzhou City Resour. Dev. Mark. Chin. J. 2023 39 1619 1627 10.3969/j.issn.1005-8141.2023.12.007
Tan X. Explaining Provincial Government Health Expenditures in China: Evidence from Panel Data 2007–2013 China Financ. Econ. Rev. 2017 5 9 10.1186/s40589-017-0054-2
Zhang D. Rahman K.M.A. Government Health Expenditure, OUT-OF-POCKET Payment and Social Inequality: A CROSS-NATIONAL Analysis of China and OECD Countries Int. J. Health Plan. Manag. 2020 35 1111 1126 10.1002/hpm.3017
Zhang J. Chang Y. Zhang L. Li D. Do Technological Innovations Promote Urban Green Development?—A Spatial Econometric Analysis of 105 Cities in China J. Clean. Prod. 2018 182 395 403 10.1016/j.jclepro.2018.02.067
Hu F. Qiu L. Xiang Y. Wei S. Sun H. Hu H. Weng X. Mao L. Zeng M. Spatial Network and Driving Factors of Low-Carbon Patent Applications in China from a Public Health Perspective Front. Public Health 2023 11 1121860 10.3389/fpubh.2023.1121860
14th Five-Year Plan for the National Economic and Social Development of the People’s Republic of China and the Long-Range Objectives Through the Year 2035 Available online: http://www.gjbmj.gov.cn/n1/2021/0315/c409080-32051071.html (accessed on 15 August 2024)
Zhu J. Chertow M.R. Greening Industrial Production through Waste Recovery: “Comprehensive Utilization of Resources” in China Environ. Sci. Technol. 2016 50 2175 2182 10.1021/acs.est.5b05098 26789437
Shu Z. Wang Z. Chen R. Li M. Lou J. Huang X. Wu J. Jing L. Allocation and Development of the General Practitioner Workforce in China from 2012 to 2015: A Literature Review Lancet 2017 390 S91 10.1016/S0140-6736(17)33229-4
Yu Q. Yin W. Huang D. Sun K. Chen Z. Guo H. Wu D. Trend and Equity of General Practitioners’ Allocation in China Based on the Data from 2012–2017 Hum. Resour. Health 2021 19 20 10.1186/s12960-021-00561-8
Liu H. Fang C. Fan Y. Mapping the Inequalities of Medical Resource Provision in China Reg. Stud. Reg. Sci. 2020 7 568 570 10.1080/21681376.2020.1848615
Kim H. Mahmood A. Goldsmith J.V. Chang H. Kedia S. Chang C.F. Access to Broadband Internet and Its Utilization for Health Information Seeking and Health Communication among Informal Caregivers in the United States J. Med. Syst. 2021 45 24 10.1007/s10916-021-01708-9 33452625
Milinovich G.J. Williams G.M. Clements A.C.A. Hu W. Internet-Based Surveillance Systems for Monitoring Emerging Infectious Diseases Lancet Infect. Dis. 2014 14 160 168 10.1016/S1473-3099(13)70244-5
Wu W. Zhu D. Liu W. Wu C.-H. Empirical Research on Smart City Construction and Public Health under Information and Communications Technology Socioecon. Plann. Sci. 2022 80 100994 10.1016/j.seps.2020.100994
Wang L. Xie Q. Xue F. Li Z. Does Smart City Construction Reduce Haze Pollution? Int. J. Environ. Res. Public Health 2022 19 16421 10.3390/ijerph192416421 36554300
Rocha N.P. Dias A. Santinha G. Rodrigues M. Queirós A. Rodrigues C. Smart Cities and Public Health: A Systematic Review Procedia Comput. Sci. 2019 164 516 523 10.1016/j.procs.2019.12.214
Zhao W. Zou Y. Smart Urban Governance in Epidemic Control: Practices and Implications of Hangzhou Chin. Public Adm. Rev. 2021 12 51 60 10.1177/153967542101200104
Zhang Z. Huang Q. Lu Y. Li M. Chen Z. LI F. Analysis of Life Expectancy and the Spatial Differences of Its Influencing Factors of Chinese Residents J. Geo-Inf. Sci. 2021 23 1575 1585 10.12082/dqxxkx.2021.200607
Jain-Chandra M.S. Khor N. Mano R. Schauer J. Wingender M.P. Zhuang J. Inequality in China–Trends, Drivers and Policy Remedies International Monetary Fund Washington, DC, USA 2018 1-4843-5753-1
Zhong D. Lu Q. Zhang Y. Li J. Lei T. Liu C. How a Poverty Alleviation Policy Affected Comprehensive Disaster Risk Reduction Capacity: Evidence from China’s Great Western Development Policy Int. J. Disaster Risk Reduct. 2024 111 104656 10.1016/j.ijdrr.2024.104656
Yang F. Yang M. Xue B. Luo Q. The Effects of China’s Western Development Strategy Implementation on Local Ecological Economic Performance J. Clean. Prod. 2018 202 925 933 10.1016/j.jclepro.2018.08.203
Pan J. Shallcross D. Geographic Distribution of Hospital Beds throughout China: A County-Level Econometric Analysis Int. J. Equity Health 2016 15 179 10.1186/s12939-016-0467-9
Zhang X. Zhao L. Cui Z. Wang Y. Study on Equity and Efficiency of Health Resources and Services Based on Key Indicators in China PLoS ONE 2015 10 e0144809 10.1371/journal.pone.0144809 26679187
Liu Y. Rao K. Wu J. Gakidou E. China’s Health System Performance Lancet 2008 372 1914 1923 10.1016/S0140-6736(08)61362-8 18930536
