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@article{Macdonald:2025:10.1016/j.ssmph.2025.101875,
author = {Macdonald, L and Nicholls, N and Caryl, F and Olsen, JR and Fecht, D and Mitchell, R},
doi = {10.1016/j.ssmph.2025.101875},
journal = {SSM - Population Health},
title = {Is objectively measured exposure to built and natural environment associated with population-level cardiovascular disease mortality in Great Britain?},
url = {http://dx.doi.org/10.1016/j.ssmph.2025.101875},
volume = {32},
year = {2025}
}
TY - JOUR
AB - BackgroundCardiovascular disease (CVD) causes one-third of global mortality, with modifiable risk factors such as unhealthy diet, sedentary behaviour, tobacco/alcohol use contributing to 80 % of CVD deaths. The built environment (BE) can influence CVD risk indirectly by shaping health behaviours and directly through environmental exposures like air pollution. While research has established connections between isolated environmental features and CVD, this study addresses significant research gaps in understanding how multiple BE characteristics influence CVD mortality across socioeconomic contexts, aiming to inform neighbourhood design to reduce both CVD and inequalities.MethodsWe modelled, for small areas across GB, tree cover, air pollution, walkability, densities of health-detrimental amenities (‘bads’) (e.g. fast-food outlets) and health-promoting amenities (‘goods’) (e.g. gyms), and income deprivation. Generalised linear models were used to assess associations between small area features and (sex-stratified) age-standardised CVD mortality rates (i.e. ICD-10 codes I00–I99), controlling for deprivation, urban-rural, country, and local authority. Combined models (i.e. models mutually adjusted for all BE features) identified the unique contribution of each feature while accounting for those that ‘co-located’. Interaction analysis was performed to examine variations by income deprivation.ResultsA slight increase in CVD mortality risk was associated with greater ‘goods’ densities (female mortality ratio (MR):1.005 (CIs:1.003–1.007), p < 0.001, male MR:1.005 (CIs:1.003–1.006), p < 0.001), and higher air pollution (female MR:1.006 (CIs:1.003–1.009), p < 0.001, male MR:1.008 (CIs:1.005–1.009), p < 0.001). A slight decrease in CVD mortality was associated with higher walkability for females (MR:0.996 (CIs:0.992–0.999), p = 0.034) and tree cover for males (MR:0.999 (CIs:0.998&nd
AU - Macdonald,L
AU - Nicholls,N
AU - Caryl,F
AU - Olsen,JR
AU - Fecht,D
AU - Mitchell,R
DO - 10.1016/j.ssmph.2025.101875
PY - 2025///
SN - 2352-8273
TI - Is objectively measured exposure to built and natural environment associated with population-level cardiovascular disease mortality in Great Britain?
T2 - SSM - Population Health
UR - http://dx.doi.org/10.1016/j.ssmph.2025.101875
UR - https://doi.org/10.1016/j.ssmph.2025.101875
VL - 32
ER -
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