Affiliation:
1. National Centre for Healthy Ageing Melbourne Victoria Australia
2. Peninsula Clinical School, Central Clinical school, Faculty of Medicine Monash University Melbourne Victoria Australia
3. Peninsula Health Melbourne Victoria Australia
4. Developmental Imaging Murdoch Children's Research Institute Melbourne Victoria Australia
5. School of Public Health The University of Sydney Sydney New South Wales Australia
6. Public Health Research Analytics and Methods for Evidence, Public Health Unit Sydney Local Health District Camperdown New South Wales Australia
7. Environmental Protection Authority Melbourne Victoria Australia
8. University of Melbourne Melbourne Victoria Australia
9. CSIRO Aspendale Victoria Australia
Abstract
AimTo examine associations of neighborhood greenery, air pollution and walkability with cardiometabolic disease in adults aged ≥45 years in the Frankston–Mornington Peninsula region, Victoria, Australia.MethodsA cross‐sectional, ecological study design was used. We assessed mean annual neighborhood greenery using the Normalized Difference Vegetation Index; air pollution (fine particulate matter of diameter ≤2.5 μm [PM2.5] and NO2) using land‐use regression models; and walkability using Walk Score (possible values 0–100). Medically diagnosed diabetes (~95% type‐2), heart disease and stroke were self‐reported in the Australian Census (2021). Multivariable regression was used to model associations between environmental exposures and area‐level (neighborhood) cardiometabolic disease prevalence (age group ≥45 years), with socioeconomic status, age and sex as covariates. Air pollution was examined as a mediator of associations between greenery and disease prevalence.ResultsOur sample comprised 699 neighborhoods with the following mean (SD) values: Normalized Difference Vegetation Index 0.47 (0.09), PM2.5, 8.5 (0.6) μg/m3 and NO2, 5.2 (1.6) ppb. Disease prevalences were: heart disease, mean 8.9% (4.5%); diabetes, mean 10.3% (4.7%); and stroke, median 1.2% (range 0–10.9%). Greenery was negatively associated with diabetes (β = −5.85, 95% CI −9.53, −2.17) and stroke prevalence (β = −1.26, 95% CI −2.11, −0.42). PM2.5 and NO2 were positively associated with diabetes (β = 1.59, 95% CI 1.00, 2.18; β = 0.42, 95% CI 0.22, 0.62) and stroke prevalence (β = 0.15, 95% CI 0.01, 0.29; β = 0.06, 95% CI 0.01, 0.10). The association between greenery and diabetes was partially mediated by PM2.5 (mediated effect −5.38, 95% CI −7.84, −3.03).ConclusionsGreenery and air pollutants were associated with lower and higher prevalence, respectively, of self‐reported diabetes and, to a lesser extent, stroke. These ecological findings require further exploration with stronger, longitudinal study designs to inform public health policy and directions. Geriatr Gerontol Int 2023; ••: ••–••.