The association between neighborhood greenness and cardiovascular disease: an observational study

Abstract

BackgroundPrevious studies have demonstrated links between cardiovascular disease and physical inactivity and poor air quality, which are both associated with neighborhood greenness. However, no studies have directly investigated neighborhood greenness in relation to coronary heart disease risk. We investigated the effect of neighborhood greenness on both self-reported and hospital admissions of coronary heart disease or stroke, accounting for ambient air quality, socio-demographic, behavioral and biological factors.MethodCross-sectional study of 11,404 adults obtained from a population representative sample for the period 2003–2009 in Perth, Western Australia. Neighborhood greenness was ascertained for a 1600 m service area surrounding the residential address using the mean and standard deviation of the Normalized Difference Vegetation Index (NDVI) obtained from remote sensing. Logistic regression was used to assess associations with medically diagnosed and hospitalization for coronary heart disease or stroke.ResultsThe odds of hospitalization for heart disease or stroke was 37% (95% CI: 8%, 57%) lower among adults in neighborhoods with highly variable greenness (highest tertile) compared to those in predominantly green, or predominantly non-green neighborhoods (lowest tertile). This effect was independent of the absolute levels of neighborhood greenness. There was weaker evidence for associations with the mean level of neighborhood greenness.ConclusionVariability in neighborhood greenness is a single metric that encapsulates two potential promoters of physical activity - an aesthetically pleasing natural environment and access to urban destinations. Variability in greenness within a neighborhood was negatively associated with coronary heart disease and stroke.

Residential green spaces and mortality: A systematic review

“…These outcomes are hard to combine with mortality estimates if little information on the population structure is available. An Australian study showed that the odds of hospitalization for heart disease or stroke were 37% lower among adults exposed to the highest tertiles of greenness compared to those exposed to the lowest tertiles (Pereira et al 2012). A study conducted in the USA evaluating the influence on mortality of the loss of 100 million trees due to the emerald ash borer, an invasive forest pest, observed that in the infested areas mortality due to CVD and low respiratory tract illnesses was increased (Donovan et al 2013).…”

Effects of Urban Green Space on Environmental Health, Equity and Resilience

“…An observational study in Australia demonstrated that a greater variability in landscape combining trees and open green space was associated with reduced risk of cardiovascular disease and stroke (Pereira et al 2012). The authors hypothesized that variability in neighbourhood greenness reflects two factors promoting physical activity -an aesthetically pleasing natural environment and access to urban destinations.…”

Metrics in Urban Health: Current Developments and Future Prospects

“…An urban sprawl index is a composite measure commonly identified by four characteristics: low residential density; rigidly separated homes, shops, and workplaces; roads with large blocks and poor access; and a lack of well-defined activity centers (45). Public spaces such as green or open spaces are linked to various health outcomes in research, including violence (62), general health and well-being (55, 109), obesity (86), and cardiovascular health (77). Although traditional metrics of access to parks using proximity indicators can be used, one can apply a variety of indices to capture multiple dimensions.…”