Associations of greenness, public parks, and blue space with cardiovascular and respiratory disease hospitalization in the US Medicare cohort
Year: 2022
Type: conference-abstract
Abstract: Background and Aim: Natural environments have been linked to decreased risk of cardiovascular disease (CVD) and respiratory disease (RSD) mortality. However, few cohort studies have looked at associations of natural environments with CVD or RSD hospitalization. Our aim was to evaluate these associations in a cohort of U.S. Medicare beneficiaries (~63 million individuals). Methods: Our open cohort included all fee-for-service Medicare beneficiaries (2000-2016), aged ≥65, living in the contiguous U.S. We assessed zip code-level average greenness (Normalized Difference Vegetation Index, NDVI), public park cover based on the United States Geological Survey Protected Areas Database, and percent blue space cover based on Landsat satellite images. Cox-equivalent Poisson models were used to estimate associations of the exposures with first CVD and RSD hospitalization in the full cohort and among those living in urban zip codes (≥1000 persons/mile2). Results: NDVI was weakly negatively correlated with percent public park cover (Spearman ρ = -0.23) and not correlated with percent blue space (Spearman ρ = 0.00). After adjustment for potential confounders, an IQR (0.27) increase in NDVI was negatively associated with CVD (HR: 0.97, 95%CI: 0.96, 0.97), but not with RSD hospitalization (HR: 0.99, 95%CI: 0.98, 1.00). In urban zip codes, an IQR increase in NDVI was positively associated with RSD hospitalization (HR: 1.02, 95%CI: 1.00, 1.03). Percent public park cover was not associated with CVD or RSD hospitalization in the full or urban population. In stratified analyses, percent public park cover was negatively associated with CVD and RSD hospitalization for Medicaid eligible individuals and individuals living in low socioeconomic status neighborhoods in the urban population. We observed no associations of percent blue space cover with CVD or RSD hospitalization. Conclusions: This study suggests that natural environments may benefit cardiorespiratory health; however, benefits may be limited to certain contexts and certain health outcomes.
Source: ISEE Conference Abstracts
Language: English
Topic: Urban Green Space and Health
Subfield: Health, Toxicology and Mutagenesis
Field: Environmental Science
Domain: Physical Sciences
Open Access status: diamond
OpenAlex ID: W4320066175