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The association between neighborhood greenness and cardiovascular disease: an observational study


Pereira, G and Foster, S and Martin, K and Christian, H and Boruff, BJ and Knuiman, M and Giles-Cort, B, The association between neighborhood greenness and cardiovascular disease: an observational study, BMC Public Health, 12 Article 466. ISSN 1471-2458 (2012) [Refereed Article]

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Copyright Statement

2012 Pereira et al.; licensee Biomed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution 2.0 Generic License (CC BY 2.0)(, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

DOI: doi:10.1186/1471-2458-12-466


Background: Previous studies have demonstrated links between cardiovascular disease and physical inactivity and poor air quality, which are both associated with neighborhood greenness. However, no studies have directly investigated neighborhood greenness in relation to coronary heart disease risk. We investigated the effect of neighborhood greenness on both self-reported and hospital admissions of coronary heart disease or stroke, accounting for ambient air quality, socio-demographic, behavioral and biological factors.

Method: Cross-sectional study of 11,404 adults obtained from a population representative sample for the period 20032009 in Perth, Western Australia. Neighborhood greenness was ascertained for a 1600 m service area surrounding the residential address using the mean and standard deviation of the Normalized Difference Vegetation Index (NDVI) obtained from remote sensing. Logistic regression was used to assess associations with medically diagnosed and hospitalization for coronary heart disease or stroke.

Results: The odds of hospitalization for heart disease or stroke was 37% (95% CI: 8%, 57%) lower among adults in neighborhoods with highly variable greenness (highest tertile) compared to those in predominantly green, or predominantly non-green neighborhoods (lowest tertile). This effect was independent of the absolute levels of neighborhood greenness. There was weaker evidence for associations with the mean level of neighborhood greenness.

Conclusion: Variability in neighborhood greenness is a single metric that encapsulates two potential promoters of physical activity - an aesthetically pleasing natural environment and access to urban destinations. Variability in greenness within a neighborhood was negatively associated with coronary heart disease and stroke.

Item Details

Item Type:Refereed Article
Keywords:coronary heart disease, stroke, cardiovascular disease, greenness, built environment
Research Division:Biomedical and Clinical Sciences
Research Group:Cardiovascular medicine and haematology
Research Field:Cardiology (incl. cardiovascular diseases)
Objective Division:Culture and Society
Objective Group:Sport, exercise and recreation
Objective Field:Exercise
UTAS Author:Martin, K (Professor Karen Martin)
ID Code:153980
Year Published:2012
Web of Science® Times Cited:148
Deposited By:Education
Deposited On:2022-10-20
Last Modified:2022-11-02
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