The association between neighborhood greenness and cardiovascular disease: an observational study

BMC Public Health

Billie Giles-Corti²  Matthew Knuiman⁴  Bryan J Boruff³  Hayley Christian¹  Karen Martin¹  Sarah Foster¹  Gavin Pereira¹ 

[1] Centre for the Built Environment and Health, School of Population Health, The University of Western Australia, 35 Stirling Highway, Crawley, WA, 6009, Australia;McCaughey VicHealth Centre for the Promotion of Mental Health and Community Wellbeing, Melbourne School of Population Health, The University of Melbourne, 207 Bouverie Street, Melbourne, Victoria 3010, Australia;School of Earth and Environment, The University of Western Australia, 35 Stirling Highway, Crawley, WA, 6009, Australia;School of Population Health, The University of Western Australia, 35 Stirling Highway, Crawley, WA 6009, Australia

关键词: Built environment;    Greenness;    Cardiovascular disease;    Stroke;    Coronary heart disease;   

Others  :  1163509
DOI  :  10.1186/1471-2458-12-466

 received in 2012-02-22, accepted in 2012-06-21,  发布年份 2012

【 摘 要 】

Background

Previous studies have demonstrated links between cardiovascular disease and physical inactivity and poor air quality, which are both associated with neighborhood greenness. However, no studies have directly investigated neighborhood greenness in relation to coronary heart disease risk. We investigated the effect of neighborhood greenness on both self-reported and hospital admissions of coronary heart disease or stroke, accounting for ambient air quality, socio-demographic, behavioral and biological factors.

Method

Cross-sectional study of 11,404 adults obtained from a population representative sample for the period 2003–2009 in Perth, Western Australia. Neighborhood greenness was ascertained for a 1600 m service area surrounding the residential address using the mean and standard deviation of the Normalized Difference Vegetation Index (NDVI) obtained from remote sensing. Logistic regression was used to assess associations with medically diagnosed and hospitalization for coronary heart disease or stroke.

Results

The odds of hospitalization for heart disease or stroke was 37% (95% CI: 8%, 57%) lower among adults in neighborhoods with highly variable greenness (highest tertile) compared to those in predominantly green, or predominantly non-green neighborhoods (lowest tertile). This effect was independent of the absolute levels of neighborhood greenness. There was weaker evidence for associations with the mean level of neighborhood greenness.

Conclusion

Variability in neighborhood greenness is a single metric that encapsulates two potential promoters of physical activity - an aesthetically pleasing natural environment and access to urban destinations. Variability in greenness within a neighborhood was negatively associated with coronary heart disease and stroke.

【 授权许可】

   
2012 Pereira et al.; licensee Biomed Central Ltd.

【 图 表 】

Figure 1.

Figure 2.

Figure 3.

【 参考文献 】

• [1]Cardiovascular diseases: fact sheet No. 317. http://www.who.int/mediacentre/factsheets/fs317/en/index.html webcite
• [2]Mathers CD, Vos ET, Stevenson CE, Begg SJ: The burden of disease and injury in Australia. Bull World Health Organ 2001, 79(11):1076-1084.
• [3]Lloyd-Jones D, Adams R, Carnethon M, De Simone G, Ferguson TB, Flegal K, Ford E, Furie K, Go A, Greenlund K, et al.: Heart disease and stroke statistics: 2009 update. Circulation 2009, 119(3):480-486.
• [4]WHO: Global atlas on cardiovascular disease prevention and control. Edited by Mendis S, Puska P, Norrving B. WHO, Geneva; 2011. http://whqlibdoc.who.int/publications/2011/9789241564373_eng.pdf webcite
• [5]Humpel N, Owen N, Leslie E: Environmental factors associated with adults’ participation in physical activity: A review. Am J Prev Med 2002, 22(3):188-199.
• [6]Frank LD, Schmid TL, Sallis JF, Chapman J, Saelens BE: Linking objectively measured physical activity with objectively measured urban form: Findings from SMARTRAQ. Am J Prev Med 2005, 28(2, Supplement 2):117-125.
• [7]Owen N, Humpel N, Leslie E, Bauman A, Sallis JF: Understanding environmental influences on walking: Review and research agenda. Am J Prev Med 2004, 27(1):67-76.
• [8]Kaczynski AT, Henderson KA: Environmental Correlates of Physical Activity: A Review of Evidence about Parks and Recreation. Leis Sci 2007, 29(4):315-354.
• [9]Sugiyama T, Francis J, Middleton NJ, Owen N, Giles-Corti B: Associations between recreational walking and attractiveness, size, and proximity of neighborhood open spaces. Am J Public Health 2010, 100(9):1752.
• [10]De Bourdeaudhuij I, Sallis JF, Saelens BE: Environmental correlates of physical activity in a sample of Belgian adults. Am J Health Promot 2003, 18(1):83-92.
• [11]Lillesand TM, Kiefer RW, Chipman JW: Remote sensing and image interpretation. 5th edition. Wiley, New Jersey; 2004.
• [12]US Department of Health Human Services: 2008 Physical Activity Guidelines for Americans. United States Department of Health and Human Services, Washington DC; 2008.
• [13]Brook RD, Rajagopalan S, Pope CA, Brook JR, Bhatnagar A, Diez-Roux AV, Holguin F, Hong Y, Luepker RV, Mittleman MA, et al.: Particulate matter air pollution and cardiovascular disease: an update to the scientific statement from the American Heart Association. Circulation 2010, 121(21):2331-2378.
• [14]Kan H: Prospective analysis of traffic exposure as a risk factor for incident coronary heart disease: the Atherosclerosis Risk in Communities (ARIC) study. Environ Health Perspect 2008, 116(11):1463.
• [15]Health Effects Institute: HEI Special Report 17. Traffic-related air pollution: a critical review of the literature on emissions, exposure, and health effects. Health Effects Institute, Boston, MA; 2010.
• [16]World Health Organization: Obesity: preventing and managing the global epidemic: report of a WHO consultation on obesity, Technical Report Series 894. World Health Organisation, Geneva; 2000.
• [17]Sugiyama T, Leslie E, Giles-Corti B, Owen N: Associations of neighbourhood greenness with physical and mental health: do walking, social coherence and local social interaction explain the relationships? J Epidemiol Community Health 2008, 62(5):e9.
• [18]Takano T, Nakamura K, Watanabe M: Urban residential environments and senior citizens’ longevity in megacity areas: the importance of walkable green spaces. J Epidemiol Community Health 2002, 56(12):913.
• [19]Tilt JH, Unfried TM, Roca B: Using Objective and Subjective Measures of Neighborhood Greenness and Accessible Destinations for Understanding Walking Trips and BMI in Seattle, Washington. Am J Health Promot 2007, 21(4s):371-379.
• [20]Cleveland WS, Grosse E, Shyu MJ: Local Regression Models. In Statistical Models in S. Edited by Chambers JM, Hastie T. Chapman and Hall, New York; 1992:309-376.