The influence of geographic life environments on cardiometabolic risk factors: a systematic review, a methodological assessment and a research agenda

Abstract

Recent environmental changes play a role in the dramatic increase in the prevalence of cardiometabolic risk factors (CMRFs) such as obesity, hypertension, type 2 diabetes, dyslipidemias and the metabolic syndrome in industrialized countries. Therefore, identifying environmental characteristics that are associated with risk factors is critical to develop more effective public health interventions. We conducted a systematic review of the literature investigating relationships between characteristics of geographic life environments and CMRFs (131 articles). Most studies were published after 2006, relied on cross-sectional designs, and examined whether sociodemographic and physical environmental characteristics, and more recently service environment characteristics, were associated with obesity or, to a lesser extent, hypertension. Only 14 longitudinal studies were retrieved; diabetes, dyslipidemias and the metabolic syndrome were rarely analysed; and aspects of social interactions in the neighbourhood were critically underinvestigated. Environmental characteristics that were consistently associated with either obesity or hypertension include low area socioeconomic position; low urbanization degree; low street intersection, service availability and residential density; high noise pollution; low accessibility to supermarkets and high density of convenience stores; and low social cohesion. Intermediate mechanisms between environmental characteristics and CMRFs have received little attention. We propose a research agenda based on the assessment of underinvestigated areas of research and methodological limitations of current literature.

Why the Neighborhood Social Environment Is Critical in Obesity Prevention

“…[7][8][9] Neighborhoods with poor community-level or government economic resources often have fewer resources related to the built environment, including poor recreational facilities, supermarkets, lack of functioning sidewalks, and limited access to parksall factors that may contribute to obesity. 10 In addition, neighborhood poverty also correlates with poor social environments, including higher crime rates, low aesthetic quality, poor social cohesion and social capital, and increased residential segregation.…”

Disparities in Built and Natural Features of Urban Parks: Comparisons by Neighborhood Level Race/Ethnicity and Income

“…This mirrors the broader literature that has examined associations between the built environment and obesity. Recent systematic reviews [16][17][18] concluded that generalizing across studies is not possible. In response, focus has shifted to disparities in quality and condition of parks in addition to their availability and distribution.…”

Does location matter? A proposed methodology to evaluate neighbourhood effects on cardiac arrest survival and bystander CPR

“…The patient's home neighbourhood will be used as a surrogate for patient characteristics, because previous literature shows an association between home neighbourhood and cardiac risk factors, unhealthy behaviours, and overall health. [33][34][35][36][37][38][39][40][41][42][43][44][45] The neighbourhood factors of the arrest location (i.e., the pickup address) will be used to study the effects on bystander CPR, because the emergency response (i.e., bystanders and EMS/paramedics) is contingent on the arrest location. [10][11][12][13][46][47][48] A patient's home address is recorded as mailing address with street name, street number, and postal code, whereas the pickup address is recorded as a mailing address, with latitude and longitude coordinates and a Universal Transverse Mercator (UTM) value.…”