Association between perceived neighborhood environment and health of middle-aged women living in rapidly changing urban Mongolia
Shagdarsuren et al. Environmental Health and Preventive Medicine
Association between perceived neighborhood environment and health of middle-aged women living in rapidly changing urban Mongolia
Tserendulam Shagdarsuren 1
Keiko Nakamura 0 1
Layla McCay 1 2
0 Promotion Committee for Healthy Cities , Tokyo , Japan
1 Department of Global Health Entrepreneurship, Division of Public Health, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University , Yushima 1-5-45, Bunkyo-ku, Tokyo 113-8519 , Japan
2 Centre for Urban Design and Mental Health , London , UK
Background: This study was conducted in rapidly urbanizing Ulaanbaatar, Mongolia, to examine patterns of perceived neighborhood quality by residents and the associations between these patterns and self-reported general and mental health in middle-aged women. Methods: A questionnaire survey was administered to 960 women aged 40-60 years. Demographic and socioeconomic characteristics, subjects' perception of their neighborhood environment, general health status, and mental health as measured using a 12-item General Health Questionnaire (GHQ12) were reported. Results: A total of 830 women completed the questionnaire. Subjects reporting their general health as very good or good accounted for 80.3% and those with a GHQ12 ≥16, which reflects psychological distress or severe distress, accounted for 16.1%. A principal component analysis of the perceptions of neighborhood environment by the residents identified six qualities: physical environment, designed environment, neighborhood community, public safety, natural environment, and citizen services. The perception of better-quality citizen services in the neighborhood was associated with better self-reported general health (odds ratio [OR] = 1.330, 95% confidence interval [CI] 1.093-1.618), and the perception of better-quality public safety was associated with less psychological distress (OR = 0.718, 95% CI 0.589-0.876); these associations were independent of education, income, occupation, type of residential area, and number of years living in the current khoroo. Conclusions: The perception of the quality of a neighborhood environment can affect the self-reported general and mental health of residents, even after accounting for the type of residential area and individual socio-economic status. Developing high-quality neighborhoods is an essential component of good planning to promote population health in urban environments.
Urbanization; Neighborhood environment; General health; Mental health; Middle-aged women; Mongolia
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Background
Ulaanbaatar, the capital city of Mongolia, has experienced
rapid economic and population growth during the last
15 years [1]. Between 2000 and 2015, the city’s gross
domestic product (GDP) grew by 24 times to 6.6 million US
dollars (USD); during that same period, the population
grew by 80%. Ulaanbaatar is now home to 1.4 million
people. The city presently faces several economic
challenges: because of the country’s dependence on its mining
industry, fluctuations in world prices for commodities are
destabilizing the economy; nevertheless, the government
maintains increasingly expansionary fiscal policies, and a
high inflation rate (averaging 11.2% from 2007 to 2015) has
been reported [1]. Because of this level of population and
economic growth and the accompanying challenges, urban
planning is now a priority to ensure the delivery of
affordable, quality housing and favorable living environments.
The ger residence, which is a combination of traditional
nomadic tents and small houses with limited access to
urban infrastructure, and Russian-style apartment
residences, which were established between 1960 and 1980,
were the two major types of residences in Ulaanbaatar in
the early 2000s. Since the late 2000s, however, the
redevelopment of existing housing areas has led to the emergence
of new town areas consisting of comfortable, detached
houses with modern amenities to accommodate the
growing number of middle- and upper-class families. These
new towns have been established only 5–10 km from the
city center, are distant from city noise, and provide a quiet,
natural-feeling atmosphere with less air pollution in
winter, compared with other residential areas [2]. In the past,
summer residences located in the city’s outskirts were only
used during the summer time. Because of the recent
progress in infrastructure development, however, some
people now choose to live in summer house areas
throughout the year. Although only 0.3% of the
households in Ulaanbaatar were living in houses in the new
town areas in 2010, the Master Plan Agency of
Ulaanbaatar forecasts that this percentage will increase to 16.7%
by the year 2030 [3].
With the urban residential environment in Ulaanbaatar
undergoing these rapid changes, many citizens have
sought to upgrade their housing and neighborhood; as
they do so, their neighborhood environment, including
both physical and social environmental (...truncated)