مدل ارزیابی سلامت محیط بر مبنای امیکس‌های پزشکی فرادقیق
محورهای موضوعی : The place of Islamic scientific wisdom in creating urban planning and architecture works
1 - استادیار گروه معماری، دانشگاه شیراز، شیراز، ایران
2 - استادیار گروه معماری، دانشگاه شیراز، شیراز، ایران
کلید واژه: کیفیت زندگی, سلامت, طب متعالیه, پزشکی ژرف, پزشکی فرادقیق, امیکس, ارزیابی سلامت.,
چکیده مقاله :
کیفیت زندگی با جنبه‌های سلامت «انسان» و «محیط» عجین شده‌است؛ اما مطالعات در دو حوزه علوم پزشکی و علوم محیطی نشان می‌دهد که هر یک از این دو حوزه، به جنبه‌ای از سلامت اشاره می‌کند و کمتر نگاه بین‌رشته‌ای شکل گرفته‌است. گرچه در دهه‌های گذشته نظریه‌پردازان معمار و شهرساز سعی کرده‌اند ویژگی‌هایی برای سلامت محیط بر شمارند؛ اما تاکنون چهارچوبی جامع که بتواند مدلی جهت ارزیابی سلامت محیط پیشنهاد دهد، ارائه نشده‌است. متعاقب یک چهارچوب ارزیابی یکپارچه، پژوهش فعلی با استفاده از روش تحقیق ترکیبی و با هدف ادغام و هماهنگ‌سازی مدل‌های ارزیابی موجود در زمینه‌های پزشکی و محیطی انجام می‌شود. این تلاش به‌دنبال توسعه یک چهارچوب بین‌رشته‌ای نوآورانه برای ارزیابی موثر سلامت کاربر در محیط است. برای دستیابی به اهداف پژوهش، این مطالعه به بررسی کامل ابعاد و مؤلفه‌های سلامت در علوم محیطی و پزشکی می‌‌پردازد. این مطالعه با ادغام نظریه‌های محیطی مرتبط و مدل ارزیابی کیفیت فضایی، در کنار نظریه‌ها و مدل‌های اخیر علوم پزشکی، یک «مدل ارزیابی سلامت محیط» مبتنی بر چهار ماتریس را پیشنهاد می‌کند. این مدل بین‌رشته‌ای ابعاد جدیدی از سلامت محیط را در‌بر‌می‌گیرد و به طراحان و کاربران محیط‌زیست در ارزیابی جنبه‌های سلامت محیط اطراف خود کمک می‌کند، بنابراین ایجاد، بهبود و پیشرفت محیط‌های سالم برای غنی‌سازی کیفیت زندگی را تقویت می‌کند. علاوه بر این، ترکیب شاخص‌های کمی سلامت ضروری مانند مقادیر عصبی، غدد درون‌ریز و سیستم ایمنی، فرصت‌هایی را برای تحقیقات آینده برای توسعه یک «ابزار جامع اندازه‌گیری سلامت محیط» باز می‌کند که معیارهای ارزیابی حیاتی را برای تجزیه و تحلیل ویژگی‌های سلامت محیط‌های اطراف ارائه می‌کند.
The Environmental Health Evaluation Model
Based on Precision Medicine’s Omics
Sara Daneshmand*
Kaveh Fattahi**
Studies on the quality of life in the two fields of medical sciences and environmental sciences show that each one refers to an aspect of health and less interdisciplinary view has been formed. So far, a comprehensive framework for environmental health assessment with the aim of integrating and harmonizing assessment models has not been provided. Therefore, this study examines the dimensions and components of health in both areas and proposes an "environmental health evaluation model" using a mixed research method. This interdisciplinary model includes new dimensions of environmental health and by using quantitative health indicators, it paves the way for developing a "comprehensive environmental health measurement tool" and creating and improving healthy environments to enrich the quality of life.
Keywords: Quality of Life, Health, Transcendental Medicine, Deep Medicine, Precision Medicine, Omics, Health Evaluation.
Introduction:
The matter of quality of life and its defining criteria and indicators has consistently intrigued scholars across diverse fields of study. Within the realm of architecture and urban planning, the assessment of quality of life typically aligns with environmental studies, involving the creation of specialized evaluation tools and models for appraisal. A prevailing characteristic of these models is a focus on health-related aspects when gauging quality of life. Given the shift in perspective on health from a pathogenic to a salutogenic approach, there is a pressing need to adapt and devise fresh assessment frameworks to evaluate the environmental health effectively.
In today's research landscape, the realm of quality of life assessment based on health index has expanded significantly, encompassing various questionnaires like CDC HRQoL, EQ-5D, AQoL-8D, and HRQoL. This holistic approach has also seeped into the realms of architecture and urban design, where a noticeable surge in focus on health promotive and health-oriented design concepts can be observed over the past few decades. Numerous architectural theories and methodologies have emerged in this sphere recently, underlining a growing synergy between medical sciences (Rosen & Hoang, 2017; Richardson et al., 2010; Van Dillen et al., 2012) and environmental sciences (Collado et al., 2017; Hartig, 2017; Shu & Ma, 2018; Lin & Juan, 2024; Gashoot, 2023; Grigoryan, 2023; Morera-Balaguer et al., 2023; Thakur et al., 2023; Bower et al., 2019; Higuera-Trujillo, 2021; Assem et al., 2022).These intersectional studies deeply explore the profound impact of the environment on human health.
However, there has been a scarcity of results presented within an interdisciplinary framework. Consequently, establishing a comprehensive framework that explores every aspect and layer of an individual's health within the reciprocal relationship between humans and the environment, and subsequently proposes a model or tool for assessing people's health across various spatial contexts encompassing both natural and man-made environments, proves not only highly influential in enhancing the users’ quality of life but also imperative given the significance of health within contemporary societies. The compilation of such an intricate framework necessitates a profound understanding and exploration of the topics at hand, which are delineated through three pivotal inquiries:
1- What is the definition of health and what are its various dimensions and components? How have the approaches towards expressing these components evolved in medical and environmental sciences over time?
2- Can the health-related aspects of the environment be delineated through insights gained from recent medical studies?
3- Furthermore, how can we develop a comprehensive model to assess environmental health, and what specific criteria should be included in this model?
Research method:
This research explores the concept of health and its dimensions within both environmental and medical studies. Initially, a comparative analysis is conducted between detailed theories of both classic and novel medical science to develop a comprehensive structural model that integrates components and indicators from both perspectives. This model aligns the dimensions of environmental health with those of human health. Subsequently, the study establishes a hierarchical structure for a transcendental environment by correlating levels of transcendental medicine with advanced and contemporary approaches in environmental sciences. Combining the insights from the initial and subsequent analyses, the research introduces a proposed environmental health matrix. Utilizing the "space quality evaluation method," this matrix is further expanded into a detailed "environmental health evaluation model," consisting of four matrices.
Results
In this article, the dimensions of environmental health, were extracted based on the correspondence between two theories of deep medicine and transcendental medicine (Tabei and Nabipour, 2020). They was followed by an exploration of the hierarchical structure of the transcendental environment, aligned with the environment-behavior model grounded in these medical theories. The table below provides a visual representation of the research findings in this context.
Table: Hierarchical structure of transcendental environment
Discussion and conclusion
After completing the comparison and juxtaposing process, a model is introduced for assessing the health of the environment. In developing this model, the physical dimension (O and G) and the psychological dimension (C) play crucial roles as two structural components of the matrix. Additionally, by incorporating time as a third dimension (T), evaluation matrices can be constructed. Following an analysis of all matrices and determination of their dimension values, it is recommended to supplement the matrices with necessary restoration values (R) to achieve the desired status. A comprehensive breakdown of the proposed model is provided in the table below.
Table: proposed details of environmental health evaluation model
|
The restorative physical dimension of the environment (Encounter with the external stimulus of the environment and environmental treatment) |
Secondary physical-psychological dimension of the person (long time) |
Secondary physical-psychological dimension of the person (midterm) |
The primary psychological dimension of the person (short term) |
The previous psychological dimension of the person |
The previous physical dimension of the person |
The physical dimension of the environment in the existing situation |
spiritual dimension |
Dimensions of environmental health |
|
Environmental GIS for restoration (R) |
Combination variables (C) |
Personal omics ( |
Environmental GIS ( |
--- |
Components |
|||
|
Restorative properties of the environment |
Compatibility matrix |
Correlation matrix. (Mental Correlation of a person with the environment) (Range of interaction with the environment) |
Desirability matrix. (The subjective desirable of the audience) (sensation range) |
Capacity matrix of the environment |
--- |
Suggested matrices |
||
|
(range of active presence in the environment) |
(range of compatibility with the environment) |
(range of belonging to the environment) |
||||||
With the space quality evaluation method, the matrix details are effectively presented based on their respective components. This, in turn, aids in illustrating the stages of environmental health evaluation through the utilization of these matrices.The diagram below shows the environmental health assessment model.
Diagram: environmental health evaluation model
The results of the research in response to the research questions have revealed insights into various dimensions and components of health as outlined in medical and environmental studies. While physical and psychological dimensions form the foundation of most theories, the spiritual dimension remains relatively unexplored due to its ethereal nature.
Through a holistic integration of medical and environmental sciences, a more nuanced understanding of environmental components has emerged, paving the way for a comprehensive analysis. By examining the cognitive-behavioral processes through the lenses of deep medicine and transcendental medicine, the study has successfully extracted dimensions of environmental health and components crucial for evaluation.
Introducing the space quality evaluation method has further enhanced the understanding of health dimensions, leading to the development of four matrices for environmental health assessment. This model not only unravels the intricate interplay between humans and their environment but also offers practical guidance for environmental designers to create healthier spaces, ultimately enhancing the quality of life for all inhabitants. This research sets the stage for future exploration in environmental health assessment tools, emphasizing the importance of incorporating current health indicators to enhance environmental quality. The proposed model holds the potential to usher in a new era of environmental design that prioritizes human well-being and fosters sustainable environments for generations to come.
References
Assem, H. M., Khodeir, L. M., Fathy, F. (2023) Designing for human wellbeing: The integration of neuroarchitecture in design – A systematic review, Ain Shams Engineering Journal. 14(6): 102102.
Bower, I, Tucker, R, Enticott, P.G. (2019) Impact of built environment design on emotion measured via neurophysiological correlates and subjective indicators: A systematic review, Journal of Environmental Psychology; 66: 101344.
Collado, S., Staats, H., Corraliza, J. A., &Hartig, T. (2017) Restorative environments and health. In Handbook of environmental psychology and quality of life research (pp. 127-148). Springer.
Gashoot, Moamer. (2023) Healing Environment. 10.13140/RG.2.2.14025.31848. Thesis for PhD.
Grigoryan, Grigory A. (2023) The systemic effects of the enriched environment on the conditioned fear reaction, Frontiers in Behavioral Neuroscience, Vol.17, DOI=10.3389/fnbeh.2023.1227575 .Hartig, T. (2017) Restorative Environments☆. In Reference Module in Neuroscience and Biobehavioral Psychology. Elsevier. https://doi.org/https://doi.org/10.1016/B978-0-12-809324-5.05699-6
Higuera-Trujillo, J.L.; Llinares, C.; Macagno, E. (2021). The Cognitive-Emotional Design and Study of Architectural Space: A Scoping Review of Neuroarchitecture and Its Precursor Approaches. Sensors; 21: 2193.
Lin, Wan-Hsuan; Juan, Yi-Kai (2024) Examining the association between healing environments and work performance, Journal of Building Engineering, Volume 84, https://doi.org/10.1016/j.jobe.2024.108624.
Morera-Balaguer, J., Martínez-González, M.C., Río-Medina, S. et al. (2023). The influence of the environment on the patient-centered therapeutic relationship in physical therapy: a qualitative study. Arch Public Health 81, 92. https://doi.org/10.1186/s13690-023-01064-9.
Richardson, E., Pearce, J., Mitchell, R. et al. (2010) The association between green space and cause-specific mortality in urban New Zealand: an ecological analysis of green space utility. BMC Public Health 10, 240. https://doi.org/10.1186/1471-2458-10-240.
Rosen, David H., Hoang, Uyen (2017) Patient Centered Medicine: A Human Experience, Oxford University Press, 1st Edition.
Shu, S., & Ma, H. (2018) The restorative environmental sounds perceived by children. Journal of environmental psychology, 60, 72-80. https://doi.org/https://doi.org/10.1016/j.jenvp.2018.10.011
Tabei, S.Z., &Nabipour, I. (2020). Transcendent Medicine and Deep Medicine Paradigm. IRANIAN SOUTH MEDICAL JOURNAL (ISMJ), 23(1 ), 70-86. SID. https://sid.ir/paper/361546/en [in persian].
Thakur, J. S.; Kaur, Rajbir; Rana, Anjalil; Paika, Ronika; Singh, Sukriti; Malhotra, Samir (2023). Systematic review on school health program and health-promoting schools in Southeast Asian region countries. International Journal of Noncommunicable Diseases 8(4):p 170-178, Oct–Dec. DOI: 10.4103/jncd.jncd_63_23.
Van Dillen, S. M., de Vries, S., Groenewegen, P. P., &Spreeuwenberg, P. (2012) Greenspace in urban neighbourhoods and residents' health: adding quality to quantity. Journal of epidemiology and community health, 66(6), e8. https://doi.org/10.1136/jech.2009.104695.
* Corresponding Author: Assistant Professor, Department of Architecture, Shiraz University, Shiraz, Iran.
daneshmand@shirazu.ac.ir
** Assistant Professor, Department of Architecture, Shiraz University, Shiraz, Iran.
ka_fattahi@shirazu.ac.ir