Objectively Measured Built Environments and Cardiovascular Diseases in Middle-Aged and Older Korean Adults

Abstract

This study assesses the association between the objectively measured built environment and cardiovascular diseases (CVDs) in 50,741 adults from the Korean Community Health Survey. The CVD outcomes of hypertension, diabetes, dyslipidemia, stroke, and myocardial infarction (MI) or angina were derived from self-reported histories of physician diagnoses. Using ArcGIS software and Korean government databases, this study measured the built environment variables for the 546 administrative areas of Gyeonggi province. A Bayesian spatial multilevel model was performed independently in two age groups (i.e., 40–59 years or ≥60 years). After adjusting for statistical significant individual- and community-level factors with the spatial associations, living far from public transit was associated with an increase in the odds of MI or angina in middle-aged adults, while living in neighborhoods in which fast-food restaurants were concentrated was associated with a decrease in the odds of hypertension and stroke. For adults 60 or older, living farther from public physical-activity (PA) facilities was associated with a 15% increased odds for dyslipidemia, compared with living in neighborhoods nearer to PA facilities. These findings suggest that creating a built environment that provides more opportunities to engage in PA in everyday life should be considered a strategy to reduce the prevalence of CVD.

Investigating the role of the built environment, socio-economic status, and lifestyle factors in the prevalence of chronic diseases in Mashhad: PLS-SEM model

“…In the present study, no correlation was observed between the built environment and chronic diseases. The obtained result is contrary to most studies ( 62–64 ). Our findings are consistent with the findings of Maike Schulz et al ( 65 ) in Germany, who investigated the influence of the built environment on risk factors and health behavior.…”

The influence mechanism of urban built environment on cardiovascular diseases

“…We followed three main steps to investigate the in uence of urban built environment on cardiovascular diseases. First, we reviewed the existing literature and identi ed the indicators of built environment elements that affect cardiovascular diseases 33,41,42 . We then collected and processed the relevant data for these indicators.…”

“…However, the relationship between different environmental elements and cardiovascular diseases is complex and diverse, and requires advanced statistical methods and spatial analysis models to reveal. Previous studies have mainly used methods such as spatial autocorrelation analysis (Moran's I), ordinary least squares (OLS), geographically weighted regression (GWR), multiscale geographically weighted regression (MGWR), and logistic regression model to quantify and evaluate the impact of built environment on cardiovascular diseases 5,32,33 . These methods can provide useful insights, but they cannot capture the in uence size and degree of various environmental elements on cardiovascular diseases.…”

Association of neighborhood physical activity facilities with incident cardiovascular disease

“…A meta-analysis found that neighborhood environmental attributes that promote PA were associated with reductions in several CVD risk factors, including hypertension, diabetes, and obesity [ 7 ]. Moreover, the relationship between the availability of PA facilities and CVD was investigated in several studies in developed western countries, many of which were cross-sectional studies on the prevalence of CVD [ 8 , 9 ] or the cardiovascular health score [ 10 – 12 ]. A few cohort studies investigated the association of PA facilities with the risk of CVD incidence.…”