Associations Between Residential Greenspace, Socioeconomic Status, and Stroke: A Matched Case-Control Study

Area of Science:

• Environmental Health
• Epidemiology
• Public Health

Background:

• Increased residential greenspace is linked to better health outcomes, including post-stroke recovery.
• The role of greenspace as an independent stroke risk factor requires further investigation.

Purpose of the Study:

• To determine if residential greenspace is an independent risk factor for stroke.
• To analyze the association between greenspace, area deprivation index (ADI), and stroke incidence.

Main Methods:

• A retrospective, matched case-control study was conducted in Milwaukee County, Wisconsin.
• Greenspace was quantified using normalized difference vegetation index (NDVI) within a 250-meter radius of residences.
• Area Deprivation Index (ADI) data were obtained from the Neighborhood Atlas for census block tracts.

Main Results:

• Higher NDVI (greenspace) was inversely correlated with stroke risk (OR: 0.33, P=0.045).
• Living in the highest greenspace quartile reduced stroke odds by 19% compared to the lowest quartile (OR: 0.81, P=0.045).
• Higher ADI (deprivation) was associated with increased stroke risk (OR: 1.28, P=0.029), and disparities were observed in greenspace and ADI by race.

Conclusions:

• Greater residential greenspace is associated with lower odds of stroke in Milwaukee County.
• Normalized difference vegetation index (NDVI) is an independent risk factor for stroke.
• Lower socioeconomic status, indicated by ADI, is also a significant risk factor for stroke.