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Urban Blue and Green Spaces and CAC in Black Individuals
Quick Takes
- Residential green space and neighborhood walkability are important foundations of a healthy and sustainable city.
- Among Black participants, shorter distance to a river and greater green space cover (parks and forest) are associated with lower odds of CAC.
- But increased exposure to particulate matter from walking and increase in smoking in a park in socially deprived persons are risk factors for ASCVD.
Study Questions:
Is there a relationship between race, socioeconomic status, and coronary artery calcification (CAC) and proximity to urban blue and green spaces?
Methods:
This study, obtained from CARDIA (Coronary Artery Risk Development in Young Adults), included measurements (1985–1986 to 2010–2011) of blue spaces (river and shore) and green spaces (park and forest), including percentage of blue space cover, distance to the nearest river, green space cover, and distance to the nearest major park; and presence of CAC by computed tomography in 2010–2011. The associations of blue and green spaces with CAC were assessed with generalized estimating equation regression with adjustment for demographics, individual and neighborhood socioeconomic status, health-related behaviors, and other health conditions. Stratified analyses by race and neighborhood deprivation score were used to test whether the association varied according to social determinants of health.
Results:
The sample included 1,365 Black and 1,555 White participants with a mean ± standard deviation age of 50.1 ± 3.6 years. A total of 819 (28%) participants had a CAC score >0. CAC was significantly related to age, less educated, and current or previous smokers (47% vs. 35%). Among Black participants, shorter distance to a river and greater green space cover were associated with lower odds of CAC (per interquartile range decrease [1.45 km] to the river: odds ratio [OR], 0.90 [95% CI, 0.84–0.96]; per 10%-point increase of green space cover: OR, 0.85 [95% CI, 0.75–0.95]). Among participants in deprived neighborhoods, greater green space cover was associated with lower odds of CAC (per a 10%-point increase: OR, 0.89 [95% CI, 0.80–0.99]), whereas shorter distance to the park was associated with higher odds of CAC (per an interquartile range decrease [5.3 km]: OR, 1.07 [95% CI, 1.00–1.15]). Black participants in deprived neighborhoods had lower odds of CAC with shorter distance to a river (per an interquartile range decrease: OR, 0.90 [95% CI, 0.82–0.98]) and greater green space cover (per a 10%-point increase: OR, 0.85 [95% CI, 0.75–0.97]). There was no statistical interaction between the blue and green spaces and race or neighborhood characteristics in association with CAC.
Conclusions:
Longitudinally, shorter distance to a river and greater green space cover were associated with less CAC among Black participants and those in deprived neighborhoods. Shorter distance to a park was associated with increased odds of CAC among participants in deprived neighborhoods. Black participants residing in more deprived neighborhoods showed lower odds of CAC in association with greater exposure to river and green space cover.
Perspective:
Residential green space and neighborhood walkability are important foundations of a healthy and sustainable city. Previous studies have demonstrated that increasing exposure to blue and green spaces might benefit the cardiovascular health of people with few social and economic resources and those who live in more deprived neighborhoods (Hu HB, et al., Environ Pollut 2022;292:118347). It’s complicated. Green space and walkability reduce atherosclerosis, as measured with CAC, but increased exposure to particulate matter from walking and increase in smoking in socially deprived persons are conflicting risk factors for atherosclerotic cardiovascular disease (ASCVD).
Clinical Topics: Prevention
Keywords: Plaque, Atherosclerotic, Race Factors, Social Class
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