Abstract 14187: Neighborhood Walkability and Cardiovascular Risk in the United States

Abstract

Walkability may be associated with increased physical activity and thus may confer protection against cardiovascular disease and associated risk factors. We sought to characterize the association between neighborhood-level cardiovascular diseases and risk factors with neighborhood walkability across most US census tracts. Methods: The Centers for Disease Control and Prevention (CDC) PLACES dataset provided census-tract level prevalence of coronary artery disease (CAD) and cardiovascular risk factors (hypertension, high cholesterol, obesity, and diabetes). These data were matched with census tract population-weighted walkability index from the CDC’s smart location database. We calculated the mean prevalence of each cardiovascular health indicator by quartile of walkability score. We also fit a multivariable linear regression model to estimate the association between walkability index and the prevalence of CAD adjusting for age, sex, race, and the CDC'S social vulnerability index, a validated metric of socioeconomic status. Results: 70,123 census tracts were analyzed nationwide. Across walkability quartiles Q1 (least walkable) through Q4 (most walkable), we found a statistically significant decrease in the prevalence of CAD (7.0% to 5.4%). Similarly, there was a decrease in the prevalence of CVD risk factors including hypertension (35.5% to 29.7%), high cholesterol (34.5% to 29.7%), obesity (35.0% to 30.2%), and diabetes (11.6% to 10.6%) across walkability quartiles ( Figure ). After multivariable adjustment, continuous walkability index was negatively and significantly associated with the prevalence of CAD (β = -0.09, p < 0.0001). Conclusions: This nationwide analysis demonstrates that neighborhood walkability is associated with a lower prevalence of cardiovascular risk factors and CAD. Figure: Mean prevalence of cardiovascular health indicators according to walkability index quartile. BP = blood pressure, CAD = coronary artery disease.