The Impact of the Neighborhood Built Environment on the Commuting Patterns and Health of Patients with Chronic Diseases: A Case Study of Changshu, China

The health of patients with chronic diseases is affected not only by factors such as eating and living habits, but also by the neighborhood built environment, and by travel conditions. Using 18 blocks in the main urban area of Changshu, China, we performed structural equation modelling, to explore the relationships between the neighborhood built environment, the commuting patterns of patients with chronic diseases, and patient health. We first divided the commuting patterns into four categories—walking/biking, public transportation, electric vehicles/motorcycles, and cars—and conducted a street-scale questionnaire survey. Secondly, we divided ‘health’ into three latent variables—physical health, mental health, and healthy behavior—and analyzed the factors influencing the street environment. Finally, we verified our theoretical framework through a mathematical statistical analysis model. We found that: (1) service facility, environmental quality, and community safety perception in the neighborhood built environment significantly impacted commuting patterns; (2) the patient’s physical health was significantly correlated with healthy behaviors and daily commuting patterns; and (3) socioeconomic attributes directly affected neighborhood environmental satisfaction, and indirectly affected the patient’s health. Neighborhood environmental satisfaction also directly affected the patient’s health, and there was a cross-influence relationship between these factors. We propose strengthening the walkability and connectivity of the neighborhood built environment, and improving the health awareness of patients, and their willingness to participate in healthy behaviors.