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Neighborhood environment linked to CV health
A positive neighborhood environment with healthy food stores and resources for physical activity is associated with ideal CV health, according to new data from the Multi-Ethnic Study of Atherosclerosis.
Researchers analyzed data from the baseline examination of MESA, conducted between 2000 and 2002 (n=5,649; mean age, 61.6 years; 52% women). Each participant was classified as having an ideal, intermediate or poor score in seven components of CV health: physical activity, diet, blood sugar, BP, BMI, total cholesterol and smoking. Participants received 0 points for a poor score, 1 point for an intermediate score and 2 points for an ideal score. The components were added to create an overall CV health score, with a total score of 0-8 classified as poor, 9-10 intermediate and 11-14 ideal.
Erin Unger, MD, from Northwestern University Feinberg School of Medicine, and colleagues then performed multinominal logistic regression to determine whether certain neighborhood characteristics were associated with ideal and intermediate CV health.
At baseline, 21.1% of participants had an ideal CV health score, 33.2% had an intermediate score and 45.8% had a poor score.
In fully adjusted models, the following characteristics were associated with higher odds of an ideal CV health score:
- Favorable food stores, defined as those likely to have fresh fruits and vegetables, within a 1-mile radius (OR=1.22; 95% CI, 1.06-1.4).
- Physical activity resources, defined as physical activity facilities within a 1-mile radius (OR=1.19; 95% CI, 1.08-1.31).
- Walking/physical activity environment, obtained from responses to a seven-question survey (OR=1.2; 95% CI, 1.05-1.37).
- Neighborhood socioeconomic status, derived from variables representing wealth, income, education and occupation (OR=1.22; 95% CI, 1.11-1.33).
After adjustment, the researchers found no relationship between ideal CV health score and safety, social cohesion or healthy food availability, a metric derived from a survey.
Among men, the odds of having an intermediate CV health score were 23% greater for every 1 standard deviation increase in favorable food stores, and the odds of having an ideal CV health score were 36% greater for every 1 standard deviation increase in favorable food stores. Among women, the researchers observed no relationship between favorable food stores and ideal or intermediate CV health score.
Healthy food availability, walking/physical activity environment, safety and neighborhood socioeconomic status were associated with having greater odds of an ideal CV health score in women, but the same trend was not observed in men.
These findings are consistent with previous studies that analyzed neighborhood characteristics and individual CVD risk factors. However, “an examination of overall [CV health], as opposed to individual components, provides a more holistic representation of overall health and may suggest that neighborhood interventions could affect [CV health] and CVD outcomes more meaningfully and efficiently than approaches targeting single risk factors,” the researchers wrote.
Disclosure: The study was funded by the NHLBI and the National Center for Research Resources. The researchers report no relevant financial disclosures.