Cross-sectional associations between residential environmental exposures and cardiovascular diseases

Abstract

BackgroundPrior research examining neighbourhood effects on cardiovascular diseases (CVDs) has focused on the impact of neighbourhood socio-economic status or a few selected environmental variables. No studies of cardiovascular disease outcomes have investigated a broad range of urban planning related environmental factors. This is the first study to combine multiple neighbourhood influences in an integrated approach to understanding the association between the built and social environment and CVDs. By modeling multiple neighbourhood level social and environmental variables simultaneously, the study improved the estimation of effects by accounting for potential contextual confounders.MethodsData were collected using a cross-sectional survey (n = 2411) across 87 census tracts (CT) in Toronto, Canada, and commercial and census data were accessed to characterize the residential environment. Multilevel regressions were used to estimate the associations of neighbourhood factors on the risk of CVD.ResultsExposure to violent crimes, environmental noise, and proximity to a major road were independently associated with increased odds of CVDs (p < 0.05) in the fully adjusted model. While reduced access to food stores, parks/recreation, and increased access to fast food restaurants were associated with increased odds of CVDs in partially adjusted models (p < 0.05), these associations were fully attenuated after adjusting for BMI and physical activity. Housing disrepair was not associated with CVD risk.ConclusionsThese findings illustrate the importance of measuring and modeling a broad range of neighborhood factors— exposure to violent crimes, environmental noise, and traffic, and access to food stores, fast food, parks/recreation areas— to identify specific stressors in relation to adverse health outcomes. Further research to investigate the temporal order of events is needed to better understand the direction of causation for the observed associations.

Fatores de risco para mortalidade por doenças cardiovasculares associados à alta exposição ao tráfego veicular

“…This paper results are in agreement with several recent studies 5,7,18,19 , which show that a residential proximity of up to 150 meters to a roadway of great vehicle flow increases the risk in CD mortality. Residential proximity to traffic is a measure of indirect exposure used as a proxy of exposure to air pollutants from traffic.…”

“…Residential proximity to traffic is a measure of indirect exposure used as a proxy of exposure to air pollutants from traffic. It has also been used to mainly characterize the chronic exposure to these pollutants, considering the residential place might be related to continuous exposure, which would make the effects gradual on health and cumulative throughout life 7,19 . Several authors have found that chronic exposure to air pollution from vehicular traffic increases the progression and instability of atherosclerosis through inflammatory processes, thus promoting other ischemic events 4,5,18 that not only create the disease, but also enhance an existing pathological condition 4,6 .…”

Retail food environments research in Canada: A scoping review

“…For example, a higher density of fast-food outlets around the home was associated with fast-food purchasing frequency among adolescents in London, ON, 35 and cardiovascular disease was positively associated with fast-food outlet density among adults living in Toronto. 36 Studies were diverse in terms of study populations, sample size, design, outcomes of interest and findings by area-level exposures of interest (socio-economic status, demographic characteristics and food environment exposures) (Supplementary Table 1). …”

Public health in linkage to land use: Theoretical framework, empirical evidence, and critical implications for reconnecting health promotion to land use policy

“…However, these disciplines have been divergent and currently operate in separate fields (Harris et al, 2016;Koohsari et al, 2013;Wernham, 2011). Yet recent literature has linked land use to a wide range of illness and death causes in developed nations, including the asthma (Son et al, 2015), high blood pressure (Langerudi et al, 2015), cancer (LopezCima et al, 2011), cardiovascular disease (Chum and O'Campo, 2015;Réquia Júnior et al, 2015), injury (Factor et al, 2013), mental disease (Barton and Pretty, 2010), obesity (Brown et al, 2009), and general health (Gascon et al, 2016;Richardson and Mitchell, 2010). Scholars have good theoretical reasons to believe the empirical linkages, since land use can shape the inhabitants' lifestyles and subsequently impacts their health (Brown et al, 2009;Heinrich et al, 2010;Wu et al, 2016).…”