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Interplay Between Residential Nature Exposure and Walkability and Their Association with Cardiovascular Health.

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Higher quality green space access is linked to better cardiovascular health. Integrating nature with walkable environments is key for protecting against cardiovascular disease.

Keywords:
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Area of Science:

  • Environmental Health
  • Cardiovascular Medicine
  • Public Health

Background:

  • Green space exposure is associated with cardiovascular (CV) health.
  • Nature access and quality significantly impact CV risk factors and overall health outcomes.

Purpose of the Study:

  • To investigate the relationship between NatureScore, a composite measure of natural environment exposure and green space quality, and CV risk factors.
  • To assess the association between NatureScore and atherosclerotic cardiovascular diseases (ASCVD).

Main Methods:

  • A cross-sectional study of over one million adult patients from the Houston Methodist Learning Health System Outpatient Registry (2016-2022).
  • NatureScore, ranging from 0-100, was calculated based on residential addresses and categorized into four levels: nature deficient/light, adequate, rich, and utopia.
  • Cardiovascular risk factors included hypertension, diabetes, dyslipidemia, and obesity. Statistical adjustments were made for neighborhood walkability.

Main Results:

  • Patients in the highest NatureScore neighborhoods exhibited lower prevalence of CV risk factors and ASCVD compared to those in the lowest NatureScore neighborhoods.
  • A significant interaction was observed between NatureScore and walkability, indicating that combined high NatureScore and high walkability areas were associated with reduced CV risk factors and a higher likelihood of an optimal CV risk profile.
  • The odds ratio for lower CV risk factors in the highest NatureScore group was 0.91 (95% CI: 0.90-0.93), and for ASCVD was 0.96 (95% CI: 0.93-0.98).

Conclusions:

  • Green space positively influences health, but its protective effects on cardiovascular health are amplified when accessible through walkable environments.
  • The integration of natural environments with pedestrian-friendly infrastructure is crucial for maximizing cardiovascular disease prevention strategies.