Built Environments and Cardiovascular Health

Abstract

Purpose: This review presents a general overview of the state of evidence on the relationships between neighborhood built environments and cardiovascular health outcomes among adults. We also summarize relevant literature on the associations of built environments with active living behaviors (physical activity [PA] and sedentary behavior), as they are considered as key behavioral pathways. Review Methods: We identified recently published systematic reviews assessing associations of built environment attributes with cardiovascular health outcomes or active living behaviors. We summarized findings of the key systematic reviews and presented findings of pertinent empirical studies, where appropriate. Summary: Increasing evidence suggests that living in a place supportive of engaging in PA for transportation (eg, walkability features) and recreation (eg, parks) can be protective against cardiovascular disease (CVD) risk. Places conducive to higher levels of sedentary travel (ie, prolonged sitting in cars) may have adverse effects on cardiovascular health. The built environment of where people live can affect how active they are and subsequently their cardiovascular health. Clinical professionals are encouraged to consider the built environment features of where their patients live in counseling, as this may assist them to understand potential opportunities or barriers to active living and to propose a suitable CVD prevention strategy.

Exploring associations of greenery, air pollution and walkability with cardiometabolic health in people at midlife and beyond

“…Some previous studies that showed 40 lower hospitalization rates for cardiovascular disease, 41 as well as lower risk of incidence of cardiovascular disease, 42 did not include air pollution or walkability exposures. Chandrabose et al 21 proposed that more walkable neighborhoods have destinations to which some people still drive, creating vehicle emissions that adversely affect health. We found that higher walkability was associated with lower diabetes prevalence only in areas with lower levels of PM 2.5 .…”

“…Further analyses were run for PM 2.5 controlling for covariates and NO 2 , and vice versa. Potential interactions between walkability and air pollutants, proposed by a recent study, 21 were examined in relation to disease prevalence, with effects scaled to one unit of each exposure.…”

“…21 Further investigation is required, as more walkable neighborhoods might include more complex street networks with higher traffic volumes. 21 Hence, it is vital to construct multi-exposure models with health-related outcomes to examine potential associations between co-existing exposures.…”

“…20 Although parks and walkable neighborhoods show potential to promote cardiometabolic health, few studies have examined these environmental exposures in combination with air pollution. 21 Further investigation is required, as more walkable neighborhoods might include more complex street networks with higher traffic volumes. 21 Hence, it is vital to construct multi-exposure models with health-related outcomes to examine potential associations between co-existing exposures.…”

“…Another systematic review reported inverse associations between neighborhood walkability and risk/prevalence of type 2 diabetes, and between greenery and diabetes 20 . Although parks and walkable neighborhoods show potential to promote cardiometabolic health, few studies have examined these environmental exposures in combination with air pollution 21 . Further investigation is required, as more walkable neighborhoods might include more complex street networks with higher traffic volumes 21 .…”