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Association of Neighborhood Physical Activity Opportunities with Incident Cardiovascular Disease in the Cardiovascular Health Study

Garg, Parveen K.; Platt, Jonathan M.; Hirsch, Jana A.; Hurvitz, Philip; Rundle, Andrew; Biggs, Mary Lou; Psaty, Bruce M.; Moore, Kari; Lovasi, Gina S. (2021). Association of Neighborhood Physical Activity Opportunities with Incident Cardiovascular Disease in the Cardiovascular Health Study. Health & Place, 70.

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Abstract

We determined associations of cumulative exposures to neighborhood physical activity opportunities with risk of incident cardiovascular disease (CVD). We included 3595 participants from the Cardiovascular Health Study recruited between 1989 and 1993 (mean age = 73; 60% women; 11% black). Neighborhood environment measures were calculated using Geographic Information Systems (GIS) and annual information from the National Establishment Time Series database, including the density of (1) walking destinations and (2) physical activity/ recreational facilities in a 1- and 5-km radius around the respondent's home. Incident CVD was defined as the development of myocardial infarction, stroke, or cardiovascular death and associations with time to incident CVD were estimated using Cox proportional hazards models. A total of 1986 incident CVD cases occurred over a median follow-up of 11.2 years. After adjusting for baseline and time-varying individual and neighborhood-level confounding, a one standard deviation increase in walking destinations and physical activity/recreational facilities within 5 km of home was associated with a respective 7% (95% confidence interval (CI) = 0.87-0.99) and 12% (95% CI = 0.73-1.0) decreased risk of incident CVD. No significant associations were noted within a 1-km radius. Efforts to improve the availability of physical activity resources in neighborhoods may be an important strategy for lowering CVD.

Keywords

Cardiovascular Diseases; Physical Activity; Proportional Hazards Models; Geographic Information Systems; Recreation Centers; Built Environment; Cardiovascular Disease; Coronary-heart-disease; Census Tract Data; Older-adults; Longitudinal Associations; Risk; Resources; Time; Atherosclerosis; Survival

Urban Design & Planning Interdisciplinary PhD

The Urban Design & Planning Interdisciplinary Ph.D. at the University of Washington is one of 39 Ph.D. programs in urban and regional planning in North America, and one of the oldest, founded in 1967.

This program brings together faculty from disciplines ranging from Architecture to Sociology to focus on the interdisciplinary study of urban problems and interventions. Covering scales from neighborhoods to metropolitan areas, the program addresses interrelationships between the physical environment, the built environment, and the social, economic, and political institutions and processes that shape urban areas. The breadth of this program permits students to pursue doctoral studies in the various aspects of urban design and planning as well as in a number of related social science, natural resource, and engineering areas.

The Program seeks to prepare scholars who can advance the state of research, practice, and education related to the built environment and its relationship to society and nature in metropolitan regions throughout the world. The program provides a strong interdisciplinary educational experience that draws on the resources of the entire University, and on the laboratory provided by the Seattle metropolitan region and the Pacific Northwest. The program emphasizes the educational values of interdisciplinarity, intellectual leadership and integrity, and the social values of equity, democracy and sustainability. It seeks to promote deeper understanding of the ways in which public decisions shape and are shaped by the urban physical, social, economic, and natural environment. The program envisions its graduates becoming leaders in the international community of researchers, practitioners and educators who focus on improving the quality of life and environment in metropolitan regions.

Urban Form Lab

The Urban Form Lab (UFL) research aims to affect policy and to support approaches to the design and planning of more livable environments. The UFL specializes in geospatial analyses of the built environment using multiple micro-scale data in Geographic Information Systems (GIS). Current research includes the development of novel GIS routines for performing spatial inventories and analyses of the built environment, and of spatially explicit sampling techniques. Projects address such topics as land monitoring, neighborhood and street design, active transportation, non-motorized transportation safety, physical activity, and access to food environments. 

Research at the UFL has been supported by the U.S. and Washington State Departments of Transportation, the Centers for Disease Control and Prevention, the Robert Wood Johnson Foundation, the National Institutes of Health, and local agencies.

The Urban Form Lab is directed by Anne Vernez Moudon, Dr es Sc, a leading researcher and educator in quantifying the properties of the built environment as related to health and transportation behaviors. Philip M. Hurvitz, PhD, a veteran of geographic information science and data processing, leads data management and GIS work.