Objectively Measured Built Environments and Cardiovascular Diseases in Middle-Aged and Older Korean Adults

• Published in: International journal of environmental research and public health Vol. 18; no. 4; p. 1861
• Main Authors: Lee, Eun Young, Choi, Jungsoon, Lee, Sugie, Choi, Bo Youl
• Format: Journal Article
• Language: English
• Published: Switzerland MDPI AG 14.02.2021; MDPI
• Subjects: Adult; Adults; Age; Aged; Angina; Angina pectoris; Bayes Theorem; Bayesian analysis; Built Environment; Cardiovascular disease; Cardiovascular diseases; Cardiovascular Diseases - epidemiology; Cerebral infarction; Construction; Diabetes; Diabetes mellitus; Disease control; Disease prevention; Dyslipidemia; Fast food; Food; Humans; Hypertension; Metabolic disorders; Middle Aged; Myocardial infarction; Neighborhoods; Obesity; Population density; Public transportation; Questionnaires; Republic of Korea - epidemiology; Residence Characteristics; Restaurants; Risk factors; Sociodemographics; Statistical analysis; Stroke; Urban areas; Urban environments; Republic of Korea; built environment; angina; myocardial infarction; cardiovascular diseases; dyslipidemia; diabetes; hypertension; stroke; Korea; middle-aged and older adults
• ISSN: 1660-4601; 1661-7827; 1660-4601
• DOI: 10.3390/ijerph18041861

This study assesses the association between the objectively measured built environment and cardiovascular diseases (CVDs) in 50,741 adults from the Korean Community Health Survey. The CVD outcomes of hypertension, diabetes, dyslipidemia, stroke, and myocardial infarction (MI) or angina were derived from self-reported histories of physician diagnoses. Using ArcGIS software and Korean government databases, this study measured the built environment variables for the 546 administrative areas of Gyeonggi province. A Bayesian spatial multilevel model was performed independently in two age groups (i.e., 40-59 years or ≥60 years). After adjusting for statistical significant individual- and community-level factors with the spatial associations, living far from public transit was associated with an increase in the odds of MI or angina in middle-aged adults, while living in neighborhoods in which fast-food restaurants were concentrated was associated with a decrease in the odds of hypertension and stroke. For adults 60 or older, living farther from public physical-activity (PA) facilities was associated with a 15% increased odds for dyslipidemia, compared with living in neighborhoods nearer to PA facilities. These findings suggest that creating a built environment that provides more opportunities to engage in PA in everyday life should be considered a strategy to reduce the prevalence of CVD.