Residential environment and risk of chronic diseases: A prospective study

The impact of green-blue spaces on human health remains inconclusive, and the current understanding of disease spectrum associated with these spaces is still incomplete. We aimed to comprehensively investigate the relationship between residential environment and chronic diseases, while also examining the potential mediating role of air pollutants in these relationships. Using data from the UK Biobank, we created a residential environment score (RES) based on four types of green-blue spaces: natural environment, green space, domestic garden, and water area, with scores assigned according to the percentage of each space within a 300 m buffer. We also calculated an air pollution score derived from concentrations of NO₂, NO_x, PM_2.5, PM_2.5-10, and PM₁₀. Employing logistic regression and Cox regression models, we analyzed the associations between RES and multisystem health outcomes among 502,490 participants at baseline. Our assessment identified 41 chronic diseases across 12 categories significantly related to RES increases (false-discovery-rate adjusted P-values < 0.01). Cox regression indicated that higher RES was associated with reduced risks for 18 diseases, excluding melanoma and bladder cancer. For the 21 unreported outcomes such as iron deficiency anemia and purpura, we observed hazard ratios (95 %CI) indicating lower risks for various conditions in the highest quartile of RES compared to the lowest. Furthermore, air pollution significantly mediated the relationship between RES and over 90 % of these chronic diseases. Residential environment with abundant green-blue spaces is linked to lower risks of most chronic diseases, which is partially mediated by diminished air pollutants and largely underestimated.