A multicomponent index method to evaluate the relationship between urban environment and CHD prevalence

Area of Science:

• Environmental Health
• Cardiovascular Epidemiology
• Urban Planning

Background:

• Cardiovascular disease (CVD), particularly coronary heart disease (CHD), is a leading global cause of mortality.
• Existing research often examines single urban environmental factors' impact on CHD, overlooking complex interactions.
• Behavioral risk factors for CHD include unhealthy diet, physical inactivity, smoking, and alcohol consumption.

Purpose of the Study:

• To develop and validate multicomponent Urban Heart Health Environment (UHHE) Indexes (unweighted and weighted) based on CHD risk factors.
• To investigate the relationship between these UHHE Indexes and the prevalence of CHD.
• To explore the spatial correlation between urban environmental factors and CHD prevalence.

Main Methods:

• Development of two UHHE Indexes incorporating four key CHD behavioral risk factors.
• Prevalence calculation using coronary stent implantation (CSI) patient data from a single hospital, with corrections for underestimation.
• Application of global (Ordinary Least Squares) and local (Geographically Weighted Regression) regression analyses to assess index-prevalence relationships.

Main Results:

• Both the unweighted and weighted UHHE Indexes demonstrated a significant negative association with CHD prevalence.
• Spatial analysis revealed a non-stationary relationship, indicating geographical variations in the impact of the urban environment on CHD.
• The findings suggest that a healthier urban environment is associated with lower CHD prevalence.

Conclusions:

• The developed UHHE Indexes provide a valuable tool for identifying areas at higher risk for CHD.
• These indexes can inform targeted CHD prevention strategies and guide urban design initiatives in China.
• Integrating environmental health considerations into urban planning may contribute to reducing the burden of cardiovascular disease.