Amsterdam, Netherlands
Feeling safe from crime linked to lower risks of heart attack and death
Feeling safe from crime is associated with a 9% lower risk of premature death and a 6% lower chance of suffering a heart attack, according to a study of more than 35,000 adults presented at the ESC 2023 Congress.
"There is growing evidence that the neighborhood we live in affects our health," said study author Dr. Mengya Li of the National Center for Cardiovascular Diseases in Beijing, China. "This study highlights the importance of many aspects of our environment for heart health and longevity, including feeling safe, having shops, transportation and parks nearby, cleanliness, and feeling that our neighborhood is a good place to live and raise children." .
Researchers used data from the PURE-China study to investigate the association between neighborhood characteristics, cardiovascular disease (CVD), and death. The study included 35,730 adults between 35 and 70 years old from 115 communities (70 urban and 45 rural) in 12 provinces of China between 2005 and 2009. The average age of the participants was 51 years and 60% were women.
Trained research staff conducted face-to-face interviews to collect baseline information about the neighborhood environment using the Neighborhood Environmental Walkability Scale (NEWS). The questionnaire contains eight subscales. The scores for each subscale were summed to obtain a total NEWS score. High scores reflected positive perceptions about the community.
The eight subscales covered: 1) how long it takes to walk to stores, restaurants, banks, pharmacies, work, transit stops, and parks; 2) perceived ease of walking to shops and transport stops; 3) the distance between intersections (indicating ease of movement); 4) walking/biking infrastructure (e.g., walking sidewalks); 5) aesthetics (e.g., trees shading the pavement, interesting things to look at while walking, absence of trash); 6) traffic safety (e.g., amount of traffic, safety when crossing the street); 7) safety from crime (e.g. street lighting at night; crime rate and safe walking during the day and night); and 8) community satisfaction (e.g., with public transportation, commuting, access to shopping, a good place to live and raise children).
Participants were followed for death from all causes, death from CVD, major CVD events (defined as death from cardiovascular causes, nonfatal myocardial infarction, stroke, or heart failure), myocardial infarction, stroke, and heart failure. . The primary outcome was a composite of major CVD events and all-cause mortality.
The researchers analyzed the associations between each subscale and the total score and health outcomes after adjusting for factors that could influence the relationships, such as age, sex, body mass index, education, household income, marital status, tobacco use, alcohol consumption, physical activity, fuel for cooking at home, pollution, history of cardiovascular diseases, high blood pressure, diabetes and common medications.
During a median follow-up of 11.7 years , there were 2,034 (5.7%) all-cause deaths, of which 765 were attributed to CVD, and 3,042 (8.5%) major CVD events. A higher neighborhood environment score was associated with a 6% lower risk of the primary outcome of major cardiovascular events and all-cause mortality, a 12% lower probability of death during follow-up, and a 10% reduction in the risk of death due to CVD.
The subscale with the greatest association with health outcomes was safety from crime. A higher neighborhood safety score was associated with a 9% lower risk of death during follow-up, a 10% lower risk of CVD death, a 3% lower likelihood of serious CVD, a 6% lower risk of myocardial infarction and 10% less probability of suffering from cardiovascular diseases.
For all subscales, a high score was associated with a lower risk of death from all causes during follow-up, with percentages ranging from 2% to 9% lower risk. Additionally, a high score on the subscale covering how long it takes to walk to services was also associated with a 1% lower risk of death due to cardiovascular disease, serious cardiovascular disease and heart attacks.
Dr Li said: “While some of the percentage reductions in risk are small, they affect a large number of people and could therefore have a wide-ranging impact. Policymakers can use the findings to take measures to mitigate the adverse effect of poor community conditions on health, such as improving local services and transport connectivity, providing green spaces and street lighting, and building walking trails. , running and cycling.”
Reference : “Associations of built environment characteristics using NEWS questionnaires with major cardiovascular diseases and all-cause mortality” Session Environmental and occupational aspects of heart disease.
