Deep learning analysis of Google Street View to assess residential built environment and cardiovascular risk in a...

Cardiovascular disease (CVD) is a leading global cause of mortality. Environmental factors are increasingly recognized as influential determinants of cardiovascular health. Nevertheless, a finer-grained understanding of the effects of the built environment remains crucial for comprehending CVD. We sought to investigate the relationship between built environment features, including residential greenspace and sidewalks, and cardiovascular risk using street-level imagery and deep learning techniques.

This study employed Google Street View (GSV) imagery and deep learning techniques to analyse built environment features around residences in relation to major adverse cardiovascular events (MACE) risk. Data from a Northeast Ohio cohort were utilized. Various covariates, including socioeconomic and environmental factors, were incorporated in Cox proportional hazards models. Of 49 887 individuals included, 2083 experienced MACE over a median follow-up of 26.86 months. Higher tree-sky index and sidewalk presence were associated with reduced MACE risk [hazard ratio (HR) = 0.95, 95% confidence interval (CI): 0.91-0.99, and HR = 0.91, 95% CI: 0.87-0.96, respectively], even after adjusting for demographic, socioeconomic, environmental, and clinical factors.

Visible vertical greenspace and sidewalks, as discerned from street-level images using deep learning, demonstrated potential associations with cardiovascular risk. This innovative approach highlights the potential of deep learning to analyse built environments at scale, offering new avenues for public health research. Future research is needed to validate these associations and better understand the underlying mechanisms.

This study examined how features of the built environment, such as greenspace and walkability, influence cardiovascular health by analysing Google Street View images using advanced deep learning techniques.Higher levels of greenspace (tree-sky index) around residences were associated with a 5% lower risk of major adverse cardiovascular events.Walkable neighbourhoods (pavement index) were linked to a 9% reduction in cardiovascular risk, independently of greenspace.