Examining the Association Between Neighborhood Walkability and Cardiovascular Health in Texas and Bexar County

Date

2023

Authors

Awadhesh Kumar, Anamika

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Abstract

Built environment plays a significant role in improving cardiovascular health. Neighborhood walkability can be seen as an important determinant of increased physical activity, thus can confer against coronary heart disease and traditional risk factors- high BP, high cholesterol, diabetes, and obesity. This project investigates the relationship between neighborhood walkability and coronary artery disease (CAD) and its risk factors at the census tract level in Texas and Bexar County separately. Additionally, it explores the mediation impact of the related risk factors on the relationship between walkability and coronary artery disease. The CDC's Places dataset, which provides the prevalence of CAD and risk factors on census tracts level, is linked with the walkability index, calculated from the US Environmental Protection Agency data. The research demonstrates a relevant decrease in the prevalence of CAD and traditional risk factors across walkability quartiles in Texas. However, there is no significant stepwise decrease is found in the prevalence of cardiovascular disease and walkability index in Bexar County. The disparity in results of the two research areas can be attributed to a smaller number of census tracts and local factors of Bexar County. Because of inconsistent findings in the prevalence of cardiovascular health within walkability quartiles in San Antonio, the regression and mediation analysis are performed for only Texas.Moreover, Spearman's correlation tests confirm a significant negative relationship between the walkability index (WI) and CAD and its risk factors in Texas. Even after adjusting for various factors, a continuous walkability index remains significantly associated with a lower prevalence of CAD in Texas. Furthermore, the association between the walkability index and CAD appears to be partially mediated by the prevalence of high blood pressure, high cholesterol, diabetes, and obesity. Overall, the analysis indicates that neighborhood walkability is linked to reduced cardiovascular risk factors and CAD prevalence in Texas. Moreover, the prevalence of risk factors partially mediates the relationship between walkability and CAD.

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Keywords

Walkability Built Environment Health Cardiovascular health

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Department

Architecture