@2024 Afarand., IRAN

---

ISSN: 2383-2150    Journal of Education and Community Health 2018;5(1):49-60

Background
.... [1, 2]. In recent years, our awareness has increased about community design, land use, transportation and traffic systems, and other environmental and social factors that affect public health [3-6].
Previous Studies
... [7-10]. Traffic and transportation are associated with environmental problems and psychological and psychological damages to citizens, including noise pollution and wasting time [11]. Traffic in cities is one of the effects of development, improvement and modernization, which can not be neglected; however control and managing traffic are one of the most important goals in urban development issues [12]. Unfortunately, not only a specific study to solve the traffic problem in Sanandaj was found, but also according to the researchers of the present study, no study was found on the effects of urban traffic on social determinants of health. ... [13].
Aim(s)
The present study was performed to determine viewpoints of urban residents and key informants in Sanandaj, Iran about the impacts of urban traffic and transport on the social determinants of health (SDH).
Research type
This research is a conventional qualitative content analysis.
Research society, place and time
This study was conducted on urban residents and key informants in Sanandaj in 2014.
Sampling method and number
Sampling was done through purposive sampling technique. Accordingly, 22 subjects were selected from Sanandaj residents by researchers based on the inclusion and exclusion criteria. Those who had more than 10 years of residence in Sanandaj with the consent to participate in the study were selected. People younger than 18 years and elderly people with cognitive problems and lack of ability to attend training sessions were excluded from the study. Eight people were invited to participate in the study as the key informant from the offices and organizations involved in traffic transportation system in Sanandaj and were expert in the relationship between traffic and health and its determinants.
Used devices&materials
The research question was answered by interview ... [14, 15]. The steps for managing and organizing information in the study are presented in Figure 1 [16]. Focus Group Discussion (FGD) was first considered for data collection due to the universality nature of the topic for residents as well as to make synergy in their responses; however for deeper digging down in the findings, the research team conducted an in-depth interview with key informants. At first, four FGD sessions were held with 22 residents, of which 6 subjects attended in 3 sessions and 4 subjects attended in 1 session. Then, those who were expert in urban traffic in Sanandaj and its effects on the health of residents (2 people) and 6 key informants (a total of 8 people) were selected and in-depth interview was conducted for them. In-depth interviews were considered for two interviewees who were more involved in the studied issue; however due to limitations of group discussion sessions, such as the limited time of sessions and speaking they could not fully express their views. Group discussions lasted from 45 minutes to one hour and in-depth interviews lasted 60-40 minutes. Group discussions were held in four months at the first author of the study office. The participants were officially invited to attend the sessions and they were contacted two weeks before the interviews. For those who agreed to attend the sessions, a letter including the study objectives as well as the reason for their participation in the sessions was sent. A day before the interview, the time of the session was reminded to the participants by telephone. In-depth interviews were conducted at the workplace of participants or at the first researcher of the study office based on the agreement of the participants. In-depth interviews with key informants were conducted almost simultaneously with group discussions in a quarterly period. All interviews were conducted by the first researcher of the study. Before explaining the study objectives, the interviewees were assured of the confidentiality of the information as well as the right to withdraw from the research. During the interviews, a note was taken by the first researcher who conducted the interviews alone. Interviews were conducted in Persian language and were recorded on the MP3 Player the content of each interview immediately transferred to a paper and analyzed. In order to achieve the required richness and repeating the obtained information, group discussion and in-depth interviews continued until data saturation. Therefore, four group discussion sessions of and eight in-depth interview sessions were held. The main topics in the group discussions and interviews included the overall description of Sanandaj city and its traffic-related problems and the impact of traffic in Sanandaj city on social determinants of health. At first, the participants’ uncertainties about social determinants of health were explained so that those who did not understand these factors could understand it. Through the interviews, more detailed questions were asked for further exploration of the factors from the participants. Through the interviews, the collected papers were reviewed by the researcher for the participants and their supplementary comments were received. The data was also presented to other researchers to be reviewed in order to increase the acceptability and their corrective comments were applied in the data. Data was managed and organized using MAXQDA10 software.
Findings by Text
In general, two groups and 13 subgroups were extracted for the research question (Table 1). According to the participants in the study, the current situation of traffic and transportation system in Sanandaj has negatively affected a set of social determinants of health, classified in two groups: socio-cultural factors and environmental factors:
Main comparison to the similar studies
In a study by Alizadeh et al. on strategies for improving the effect of the Deedgah recreational complex (Mellat Park) of the Sanandaj as a recreational space for the residents, a series of weaknesses and threats were identified, some of which are associated with urban traffic problems [17]. Grout et al. found that there is a correlation between smoking and accidents, which means that there was a significant difference between the number of accidents by drivers who smoked and those who did not smoke. ... [18]. … [19]. Similar to the findings of the present study, several studies have examined the impact of urban traffic on the insecure walking and cycling through the city [20, 21]. Consistent with the findings of this study, Shahani states that the optimal use of vegetation is one of the appropriate strategies for reducing the effects of air pollution [22]. ... [23]. Rezaei Mofrad, in his study, argues that oxides of Sulphur and Nitrogen present in the atmosphere caused by traffic jams can be combined with atmosphere moisture and physically destroy the monuments as sulfuric acid and nitric acid. ... [25]. Samani et al. studied the concentration of lead and cadmium in the soil of the roadsides of Isfahan and its association with traffic factors and concluded that the average lead and cadmium concentration of the soil up to 50 meters from the edge of the street was higher than the ground values and it was higher than the maximum standard for metal in agricultural soil [26]. ... [27-32]. According to the participants in the study, the air pollution caused by traffic is affected both plants and agricultural crops, which is in line with the findings of other studies [27, 33, 34]. ... [35]. A study in the UK showed that cardiovascular and respiratory diseases-related deaths in men decrease with an increase in the urban green spaces [36]. ... [37].
Suggestions
Similar studies are needed in other cities to find additional evidence for future interventions.
Limitations
The findings can not be generalized due to the qualitative type of this study.
Conclusions
The current state of traffic and urban transport in Sanandaj is greatly affected its health and social determinants.
Acknowledgments
The authors are thankful to all participants in the study.
Conflict of interest
None declared.
Ethical Permissions
Ethical considerations included the informed consent of the participants for recording their interviews, no need for mentioning their names in the recorded content and written texts, Secrecy and confidentiality of information, and the right of withdrawal for participants.
Funding Sources
This study is extracted from a Ph.D. Thesis in Health Education and Health Promotion, which was approved by the Tehran University of Medical Sciences (study No.: 91-3-121).

TABLES and CHARTS

Show attach file