Neighbourhood Environment and Stroke: A Follow-Up Study in Sweden

Abstract

BackgroundIn recent years, research on the association between physical environments and cardiovascular disease outcomes has gained momentum with growing attention being paid to Geographic Information Systems (GIS). This nationwide study is the first to examine the effect of neighbourhood physical environments on individual-level stroke, using GIS-based measures of neighbourhood availability of potentially health-damaging (fast food restaurants and pubs/bars) and health-promoting (physical activity and healthcare) resources.MethodsThe study population comprised a nationwide sample of 2,115,974 men and 2,193,700 women aged 35–80 years who were followed between 1 December 2005 and 31 December 2007 in Sweden. Totally 42,270 first-ever strokes (both morbidity and mortality) were identified. Multilevel logistic regression models were used to estimate the association between neighbourhood availability of four different resources (fast food restaurants, pubs/bars, physical activity and healthcare) and individual-level stroke.Principal FindingsThere were significant associations between neighbourhood availability of the four types of neighbourhood resources and individual-level stroke. The significant odds ratios varied between 1.06 and 1.12 for men and 1.07 and 1.24 for women. After adjustment for age, income, and neighbourhood-level deprivation, the increased odds remained statistically significant for neighbourhood availability of fast food restaurants in both men and women.ConclusionsSpecific neighbourhood availability of resources were associated with individual-level stroke but most of these associations were explained by individual-level sociodemographic factors and neighbourhood-level deprivation.

Built Environment, Selected Risk Factors and Major Cardiovascular Disease Outcomes: A Systematic Review

“…The year of study ranged between 2005 [21] and 2015 [22], with 27.8% (n = 5) being published in 2012 [23–27]. Sample sizes varied across studies, ranging from 102 [21] to 4,319,674 [28]. In all, 55.5% (n = 10) of the studies were conducted in urban [21,23,24,26,28–32,33] areas as compared to rural [34], suburban [27] and urban/suburban/rural [35].…”

“…Sample sizes varied across studies, ranging from 102 [21] to 4,319,674 [28]. In all, 55.5% (n = 10) of the studies were conducted in urban [21,23,24,26,28–32,33] areas as compared to rural [34], suburban [27] and urban/suburban/rural [35]. Community based studies [22,25,33,36] constituted 22.2% (n = 4) compared to one institution based study [37].…”

“…Community based studies [22,25,33,36] constituted 22.2% (n = 4) compared to one institution based study [37]. The reported ages of the participants ranged from 18 [25,27,32,33] to 80 years [28]. Most studies included females and males [21, 22,24,25,27–36] (88.9%; n = 16) with only 11.1% (n = 2) being in females only [23,26].…”

“…Sixteen studies (88.9%) were conducted in high-income countries [21–33,34, 36,38], 11.1% (n = 2) in middle income countries [35,37] and 38.9% (n = 7) were conducted in the USA alone [21,23,25,26,31,33,36]. Of all included studies, 94.4% (n = 17) were cross-sectional [21–22,26,27,29–38] with one being longitudinal [28]. …”

Exploring the Relationship between Perceptions of Neighbourhoodresources, Sense of Coherence and Health for Different Groups in a Norwegian Neighbourhood

“…Low socio-economic status and bad social climate within neighbourhoods have been linked to a number of negative health-outcomes such as accumulated stress, lower birth weight, behavioural problems, obesity, affective disorders and cardio-vascular diseases. 3-5,8,9 Lower involvement and less participation within the neighbourhood-context have been associated with unfavourable health outcomes, especially for young people. 4,10-12 Environmental stressors such as noise, pollution and traffic may have severe health- consequences; at the same time, they tend to be more prominent in deprived areas 13 …”