Spatial characteristics of health outcomes and geographical detection of its influencing factors in Beijing

Background and objective: Social determinants of health (SDOH) broadly influence health levels. Research on health and its influencing factors can help improve health status. There is limited research on the spatial stratified heterogeneity of health status and the interactions between the factors influencing it. This study aimed to analyze the spatial characteristics of health outcomes in Beijing and identify its influencing factors.

Methods: Based on the Healthy Beijing Initiative (2020-2030), we constructed health outcomes and five dimensions of the SDOH evaluation system. Our study measured the health outcomes and SDOH based on the latest data from 16 districts in Beijing in 2020-2022. We explored the spatial characteristics of health outcomes through descriptive and spatial autocorrelation analyses. Moreover, the Geographical Detector (GeoDetector) technique has been used to reveal the effect of SDOH and its interactions on health outcomes.

Results: A significant spatial stratified heterogeneity of health outcomes was observed, with the health outcomes mainly exhibiting two clustering types (high-high and low-low) with positive autocorrelation. The results of the geodetector showed that social and economic factors (q = 0.85), healthy lifestyle (q = 0.68) and health service (q = 0.53) could mainly explain the heterogeneity of health outcomes. Social and economic factors, healthy lifestyle and healthy environment gradually became the main influential factor in health outcomes over time. Furthermore, the interaction of any two factors on health outcomes was found to be more pronounced than the impact of a single factor.

Conclusion: There existed obvious spatial stratified heterogeneity of health outcomes in Beijing, which could be primarily explained by social and economic factors, and healthy lifestyle and health service.