地理学报 ›› 2022, Vol. 77 ›› Issue (3): 574-588.doi: 10.11821/dlxb202203006
收稿日期:
2021-09-03
修回日期:
2022-01-10
出版日期:
2022-03-25
发布日期:
2022-05-25
作者简介:
宋飏(1978-), 女, 吉林长春人, 博士, 高级工程师, 研究方向为城市地理与城乡规划、环境健康地理。E-mail: song0317@nenu.edu.cn
基金资助:
SONG Yang1,2(), LIU Yanxiao1, ZHANG Yu1, WANG Shijun1,2
Received:
2021-09-03
Revised:
2022-01-10
Published:
2022-03-25
Online:
2022-05-25
Supported by:
摘要:
健康中国战略是中国新时期的重大战略之一,手足口病作为全球关注的公共卫生问题,已成为中国影响范围较为广泛和普遍的典型传染性疾病,尤其对婴幼儿健康造成巨大威胁。本文构建健康地理学视角下的传染病研究理论框架,采用集中度和空间分析方法解析中国2008—2017年手足口病发病时空分异特征和变化规律,对18个影响其发病的风险因子进行空间相关和地理探测,揭示手足口病地理分异的主要影响因素和作用机理。结果表明:① 健康地理学视角下的传染病研究理论框架由传染病发病的基本环节、影响因素和分布扩散状态3个子系统构成,各子系统之间及子系统内部相互影响相互作用。② 2008—2017年中国手足口病发病率呈现波动上升、两年为一周期且偶数年份高于奇数年份的发病规律,春末夏初及秋末冬初为发病高峰。③ 2008—2010年手足口病发病率未体现明显的空间集聚特征;2011—2017年发病率存在较强的空间自相关性,热点地区主要集中在广东、广西、海南等地区,且呈现自北向南、自小而分散向大而集中的演变趋势;发病典型地区可以总结为气候湿热区、经济落后且医疗水平低的地区和易集聚感染的人口密集区3种。④ 有12项因素通过了相关分析和地理探测的显著性检验,与手足口病发病率体现正向作用的因素解释力从大到小依次为“气温>年降水量>湿度>气压>人口密度>路网密度>人均GDP”,负向相关关系作用大小依次为“日照时数>风速>AQI指数>海拔>千人床位数”,气温和降水量与其他因子的交互作用最为明显。本文为健康地理学、手足口病病理学、流行病学的相关研究提供实证检验基础,为服务健康中国战略和流行病预防与控制提供重要科学支撑和政策参考。
宋飏, 刘艳晓, 张瑜, 王士君. 中国手足口病时空分异特征及影响因素[J]. 地理学报, 2022, 77(3): 574-588.
SONG Yang, LIU Yanxiao, ZHANG Yu, WANG Shijun. Spatio-temporal differentiation characteristics and influencing factors of hand, foot, and mouth disease in China[J]. Acta Geographica Sinica, 2022, 77(3): 574-588.
表1
HFMD时空分异影响因素指标体系
准则层 | 指标层 | 英文及简称 | 数据来源 |
---|---|---|---|
自然环境 因素 | 海拔(m) | Digital elevation model, DEM | 资源环境科学与数据中心( |
年降水量(mm) | Annual precipitation, AP | 国家气象科学数据中心( | |
气压(hPa) | Barometric pressure, BP | 国家气象科学数据中心( | |
风速(m/s) | Weed speed, WS | 国家气象科学数据中心( | |
气温(℃) | Air temperature, AT | 国家气象科学数据中心( | |
相对湿度(%) | Relative humidity, RH | 国家气象科学数据中心( | |
日照时数(h) | Sunshine duration, SD | 国家气象科学数据中心( | |
AQI指数 | Air quality index, AQI | 中国环境监测总站( | |
社会经济 因素 | GDP(亿元) | Gross domestic product, GDP | 中国城市统计年鉴 |
人均GDP(万元) | Per capita GDP, PCG | 中国城市统计年鉴 | |
一产占比(%) | Proportion of primary industry, PPI | 中国县(市)社会经济统计年鉴 | |
二产占比(%) | Proportion of secondary industry, PSI | 中国县(市)社会经济统计年鉴 | |
三产占比(%) | Proportion of tertiary industry, PTI | 中国县(市)社会经济统计年鉴 | |
城市化率(%) | Urbanization rate, UR | 中国城市统计年鉴、各省市统计年鉴 | |
千人床位数(张) | Hospital beds per 1000 persons, HBP | 中国县域统计年鉴(县市卷) | |
流动人口数(人) | Mobile population, MP | 流动人口数据平台( | |
人口密度(人/km2) | Population density, PD | 全球人口动态统计数据( | |
路网密度(km/km2) | Road network density, RND | 开放街道图( |
表4
2008—2017年中国HFMD发病率的全局Moran's I分析结果
年份 | Moran's I | Z值 | p值 | 空间格局 | 年份 | Moran's I | Z值 | p值 | 空间格局 |
---|---|---|---|---|---|---|---|---|---|
2008 | 0.257 | 17.625 | 0.000 | - | 2013 | 0.604 | 44.679 | 0.000 | 集聚 |
2009 | 0.246 | 25.937 | 0.000 | - | 2014 | 0.454 | 33.834 | 0.000 | 集聚 |
2010 | 0.295 | 22.054 | 0.000 | - | 2015 | 0.686 | 50.786 | 0.000 | 集聚 |
2011 | 0.576 | 42.726 | 0.000 | 集聚 | 2016 | 0.324 | 24.201 | 0.000 | 集聚 |
2012 | 0.574 | 40.352 | 0.000 | 集聚 | 2017 | 0.659 | 46.008 | 0.000 | 集聚 |
表5
2017年HFMD发病率与影响因素Spearman相关系数
影响因素 | 相关系数 | 显著性 | 影响因素 | 相关系数 | 显著性 | 影响因素 | 相关系数 | 显著性 |
---|---|---|---|---|---|---|---|---|
气温 | 0.775** | 0.000 | 海拔 | -0.382** | 0.000 | 一产占比 | -0.202** | 0.000 |
年降水量 | 0.734** | 0.000 | 气压 | 0.323** | 0.000 | 城市化率 | 0.178** | 0.000 |
湿度 | 0.667** | 0.000 | AQI指数 | -0.319** | 0.000 | 路网密度 | 0.160** | 0.000 |
日照时数 | -0.561** | 0.000 | GDP | 0.266** | 0.000 | 流动人数 | 0.135** | 0.000 |
风速 | -0.434** | 0.000 | 人均GDP | 0.232** | 0.000 | 三产占比 | 0.105* | 0.022 |
人口密度 | 0.389** | 0.000 | 千人床位数 | -0.227** | 0.000 | 二产占比 | 0.068 | 0.096 |
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