Neighborhood walkability, a measure of how easy and safe it is to walk to reach resources for daily living, such as a grocery store, pharmacy, school, work and church, is associated with lower cardiovascular disease burden and risk, according to two preliminary studies to be presented at the American Heart Association’s Scientific Sessions 2022. The meeting, held in person in Chicago and virtually, Nov. 5-7, 2022, and is a premier global exchange of the latest scientific advancements, research and evidence-based clinical practice updates in cardiovascular science.

Cardiovascular disease is the number one cause of death in the U.S. and globally, according to the American Heart Association’s Heart Disease and Stroke Statistics—2022 Update. A key component for achieving optimal cardiovascular health and reducing cardiovascular risk is physical activity, and less than 1 in 4 U.S. adults have reported achieving the recommended amount of physical activity, according to the 2018 U.S. Department of Health and Human Services’ Physical Activity Guidelines for Americans. It recommends adults engage in at least 150 minutes a week of moderate-intensity activity or 75 minutes a week of vigorous-intensity aerobic physical activity for substantial health benefits. Physical activity is one of eight essential components of ideal heart and brain health, according to the American Heart Association’s 2022 Presidential Advisory, Life’s Essential 8.

“When a person’s environment is conducive to walking, there is a greater likelihood of engagement in physical activity such as walking,” explained Elizabeth A. Jackson, M.D., M.P.H., FAHA, past chair of the American Heart Association’s Committee on Social Determinants of Health. “Ample data support the cardiovascular benefits of regular physical activity including walking, therefore, designing neighborhoods to be walkable may assist residents in improving their cardiovascular health.”

Two new studies, by separate research groups, explored how more walkable neighborhoods may lower cardiovascular disease prevalence and cardiovascular disease risk.

Neighborhood walkability and cardiovascular risk in the United States (Abstract MP91)

In a nationwide study, more than 70,000 U.S. census tracts were analyzed to explore the potential association among neighborhood-level walkability and cardiovascular disease and cardiovascular disease risk factors.

“The way communities are designed is increasingly recognized to have an important role in cardiovascular disease and its risk factors,” said study lead author Issam Motairek, M.D., a research associate at the University Hospital Cleveland Medical Center in Cleveland. ”Walkability is a neighborhood metric reflecting how easy it is to walk in that neighborhood. Whether walking to stores, jobs or local parks, a walkable neighborhood encourages people to be more physically active and helps them stay healthy.”

Motairek and colleagues reviewed the Centers for Disease Control and Prevention’s (CDC) PLACES dataset, which tracks the prevalence in the U.S. of coronary artery disease and cardiovascular risk factors, such as high blood pressure, high cholesterol, obesity and Type 2 diabetes by census tract. Researchers matched the health information from the PLACES database with data from a census tract walkability index from the Environmental Protection Agency’s smart location database to categorize census tracts into four levels of walkability, from the least walkable to the most walkable.

The analysis found:

• Cardiovascular disease prevalence was notably lower, at 5.4%, in the most-walkable neighborhoods compared to 7% in the least-walkable neighborhoods.
• About 36% of adults living in the least-walkable neighborhoods had high blood pressure, high cholesterol or obesity, compared to about 30% in the most-walkable neighborhoods.
• Type 2 diabetes prevalence was 11.6% in the least-walkable neighborhoods compared to 10.6% in the most-walkable neighborhoods.

“Assessing walkability for each neighborhood from least-walkable to most-walkable, we found that even after considering other factors, such as sex, age, race and social vulnerability of the neighborhood, walkability alone, was associated with about a 0.1% decrease in cardiovascular disease for each one-point increase in walkability score,” Motairek said. “It’s important that public health officials consider the health implications of urban designs that encourage walkability.”