Urban imperviousness and carotid intima-medial thickness: Evidence from the Coronary Artery Risk Development in Young Adults (CARDIA) study

Dandan Zhao ¹, Jie Yao ², Yuanfei Li ¹

¹Department of Sociology, University at Albany, State University of New York, Albany, NY, USA.
²Department of Epidemiology and Biostatistics, College of Integrated Health Sciences, University at Albany, State University of New York, Rensselaer, NY, USA.
³Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, Minneapolis, MN, USA.
⁴Department of Preventive Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL, USA.
⁵School of Health Sciences, Purdue University, West Lafayette, IN, USA.
⁶Division of Intramural Research, National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, MD, USA.
⁷Division of Cardiovascular Sciences, National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, MD, USA.
⁸Department of Social Work and Sociology, John R. and Kathy R. Hairston College of Health and Human Sciences, North Carolina Agricultural and Technical State University, Greensboro, NC, USA.
⁹School of Nursing, James Madison University, Harrisonburg, VA, USA.
¹⁰Department of Environmental Health Sciences, College of Integrated Health Sciences, University at Albany, State University of New York, Rensselaer, NY, USA; Department of Population and Community Health, College of Public Health, The University of North Texas Health Science Center at Fort Worth, Fort Worth, TX, USA.

⁰Department of Sociology, University at Albany, State University of New York, Albany, NY, USA.

The Science of the Total Environment +

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April 19, 2025

View abstract on PubMed

Summary

Urban impervious surfaces may increase early cardiovascular disease risk, particularly in Black adults. Associations with carotid intima-media thickness (CIMT) vary by race and sex, highlighting complex environmental health links.

Area Of Science

Environmental health
Cardiovascular epidemiology
Urban planning

Background

Urbanization increases impervious surfaces, potentially elevating cardiovascular disease (CVD) risks via reduced walkability, heat, and pollution.
The link between imperviousness and subclinical CVD indicators like carotid intima-media thickness (CIMT) is understudied, especially across diverse populations.

Purpose Of The Study

To investigate the association between residential impervious cover and CIMT.
To determine if these associations differ by race and sex.

Main Methods

Utilized data from the National Land Cover Database (NLCD 2006) for impervious cover and the Coronary Artery Risk Development in Young Adults (CARDIA) study for CIMT.
Employed linear regression models to assess the relationship between impervious surface prevalence and CIMT in immediate and surrounding neighborhoods.
Examined variations in associations across sex and race groups.

Main Results

No overall significant association between impervious coverage and CIMT was found.
In women, impervious surfaces were positively associated with CIMT across various buffer zones (50m-5000m), an effect mitigated by social determinants of health.
Black adults showed a persistent positive association between CIMT and impervious coverage beyond a 1km buffer, irrespective of adjustments, while no significant links were observed for men or White adults.

Conclusions

Urban impervious cover may contribute to early CVD development in Black adults.
The lack of associations in smaller buffer zones and among other demographic groups underscores the intricate environmental pathways influencing cardiovascular health.

Keywords:

Built environment Carotid intima-medial thickness (CIMT) Impervious cover Race Sex