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Residential neighbourhood greenspace is associated with reduced risk of cardiovascular disease: A prospective cohort study

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  • Alice M Dalton
  • Andrew P Jones

Abstract

Background: Living in a greener neighbourhood may reduce the risk of developing incident cardiovascular disease, but evidence is limited by reliance on cross-sectional comparisons. We use data from a longitudinal study with a time-independent measure of risk to explore the association between exposure to greenspace and cardiovascular disease. Methods: Data was from the European Prospective Investigation of Cancer Norfolk UK cohort, baseline 1993–1997 (n = 24,420). Neighbourhoods were defined as 800m radius zones around participants’ home, according to their home postcode (zip code) in the year 2000. Greenspace exposure was identified using classified satellite imagery. Adjusted Cox proportional hazards regression examined associations between greenspace and incident cardiovascular disease. Mediation analysis assessed if physical activity mediated associations, whilst modification by rurality, socio-economic status and age was explored. Results: The mean age of participants was 59.2 years at baseline, 54.7% were female, and mean follow-up time was 14.5 years. Individuals living in the greenest neighbourhood quartile had a 7% lower relative hazard of developing cardiovascular disease than other neighbourhoods (HR 0.93; 95% CI 0.88, 0.97; p = 0.003) after adjusting for age, sex, BMI, prevalent diabetes and socio-economic status (SES). Physical activity did not mediate the relationship (greenest compared to the least green quartile HR 0.99; 95% CI 0.97, 1.01; p = 0.416). Models predicted incidence of cardiovascular disease in the least green neighbourhoods (19.4% greenspace on average) would fall by 4.8% (95% CI 1.6%, 8.2% p = 0.003) if they were as green as the average neighbourhood (59.0% greenspace). Occupation moderated the relationship, whereby exposure to greenspace was not associated with incident CVD for participants engaged in manual occupations. Conclusions: Greener home neighbourhoods may protect against risk of cardiovascular disease even after accounting for SES, whilst the mechanism does not appear to be strongly associated with physical activity. Putative causal mechanisms require investigation.

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  • Alice M Dalton & Andrew P Jones, 2020. "Residential neighbourhood greenspace is associated with reduced risk of cardiovascular disease: A prospective cohort study," PLOS ONE, Public Library of Science, vol. 15(1), pages 1-16, January.
    • Handle: RePEc:plo:pone00:0226524
    DOI: 10.1371/journal.pone.0226524
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    References listed on IDEAS

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    2. Roger B. Newson, 2013. "Attributable and unattributable risks and fractions and other scenario comparisons," Stata Journal, StataCorp LP, vol. 13(4), pages 672-698, December.
    3. de Vries, Sjerp & van Dillen, Sonja M.E. & Groenewegen, Peter P. & Spreeuwenberg, Peter, 2013. "Streetscape greenery and health: Stress, social cohesion and physical activity as mediators," Social Science & Medicine, Elsevier, vol. 94(C), pages 26-33.
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    1. Mariya Geneshka & Peter Coventry & Joana Cruz & Simon Gilbody, 2021. "Relationship between Green and Blue Spaces with Mental and Physical Health: A Systematic Review of Longitudinal Observational Studies," IJERPH, MDPI, vol. 18(17), pages 1-29, August.
    2. Jean C. Bikomeye & Andreas M. Beyer & Jamila L. Kwarteng & Kirsten M. M. Beyer, 2022. "Greenspace, Inflammation, Cardiovascular Health, and Cancer: A Review and Conceptual Framework for Greenspace in Cardio-Oncology Research," IJERPH, MDPI, vol. 19(4), pages 1-22, February.
    3. Tadeusz Ciupa & Roman Suligowski, 2021. "Green-Blue Spaces and Population Density versus COVID-19 Cases and Deaths in Poland," IJERPH, MDPI, vol. 18(12), pages 1-17, June.
    4. Jean C. Bikomeye & Sima Namin & Chima Anyanwu & Caitlin S. Rublee & Jamie Ferschinger & Ken Leinbach & Patricia Lindquist & August Hoppe & Lawrence Hoffman & Justin Hegarty & Dwayne Sperber & Kirsten , 2021. "Resilience and Equity in a Time of Crises: Investing in Public Urban Greenspace Is Now More Essential Than Ever in the US and Beyond," IJERPH, MDPI, vol. 18(16), pages 1-39, August.
    5. Marion Porcherie & Nyan Linn & Anne Roué Le Gall & Marie-Florence Thomas & Emmanuelle Faure & Stéphane Rican & Jean Simos & Nicola Cantoreggi & Zoé Vaillant & Linda Cambon & Jean-Philippe Regnaux, 2021. "Relationship between Urban Green Spaces and Cancer: A Scoping Review," IJERPH, MDPI, vol. 18(4), pages 1-19, February.
    6. Martha Ta & Ketan Shankardass, 2021. "Piloting the Use of Concept Mapping to Engage Geographic Communities for Stress and Resilience Planning in Toronto, Ontario, Canada," IJERPH, MDPI, vol. 18(20), pages 1-14, October.
    7. Katie Crist & Tarik Benmarhnia & Steven Zamora & Jiue-An Yang & Dorothy D. Sears & Loki Natarajan & Lindsay Dillon & James F. Sallis & Marta M. Jankowska, 2021. "Device-Measured and Self-Reported Active Travel Associations with Cardiovascular Disease Risk Factors in an Ethnically Diverse Sample of Adults," IJERPH, MDPI, vol. 18(8), pages 1-16, April.

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