Associations of the neighbourhood built and natural environment with cardiometabolic health indicators: A cross-sectional analysis of environmental moderators and behavioural mediators

被引:4
作者
Cerin, Ester [1 ,2 ,3 ,10 ]
Chan, Yih-kai [1 ]
Symmons, Mark [1 ]
Soloveva, Maria [1 ]
Martino, Erika [4 ]
Shaw, Jonathan E. [3 ,5 ,6 ]
Knibbs, Luke D. [7 ,8 ]
Jalaludin, Bin [9 ]
Barnett, Anthony [1 ]
机构
[1] Australian Catholic Univ, Mary MacKillop Inst Hlth Res, 215 Spring St, Melbourne, Vic, Australia
[2] Univ Hong Kong, Sch Publ Hlth, Sandy Bay, 7 Sassoon Rd, Hong Kong, Peoples R China
[3] Baker Heart & Diabet Inst, Melbourne, Vic, Australia
[4] Univ Melbourne, Sch Populat & Global Hlth, Melbourne, Vic, Australia
[5] Monash Univ, Sch Publ Hlth & Prevent Med, Melbourne, Vic, Australia
[6] Trobe Univ, Sch Life Sci, Melbourne, Vic, Australia
[7] Univ Sydney, Sydney Sch Publ Hlth, Camperdown, NSW, Australia
[8] Sydney Local Hlth Dist, Publ Hlth Unit, Camperdown, NSW, Australia
[9] Univ New South Wales, Sch Populat Hlth, Randwick, NSW, Australia
[10] Australian Catholic Univ, Mary MacKillop Inst Hlth Res, 215 Spring St, Melbourne, Vic 3000, Australia
关键词
Walkability; Greenspace; Blue space; Physical activity; Neighbourhood socio-economic status; Air pollution; LONG-TERM EXPOSURE; TYPE-2; DIABETES-MELLITUS; PHYSICAL-ACTIVITY; AIR-POLLUTION; SOCIOECONOMIC-STATUS; LIFE-STYLE; METABOLIC SYNDROME; DIETARY-INTAKE; OLDER-ADULTS; RISK-FACTORS;
D O I
10.1016/j.envres.2023.117524
中图分类号
X [环境科学、安全科学];
学科分类号
08 ; 0830 ;
摘要
Background: Most studies examining the effects of neighbourhood urban design on cardiometabolic health focused solely on the built or natural environment. Also, they did not consider the roles of neighbourhood socio-economic status (SES) and ambient air pollution in the observed associations, and the extent to which these associations were mediated by physical activity and sedentary behaviours.Methods: We used data from the AusDiab3 study (N = 4141), a national cohort study of Australian adults to address the above-mentioned knowledge gaps. Spatial data were used to compute indices of neighbourhood walkability (population density, intersection density, non-commercial land use mix, commercial land use), natural environment (parkland and blue spaces) and air pollution (annual average concentrations of nitrogen dioxide (NO2) and fine particulate matter <2.5 mu m in diameter (PM2.5)). Census indices were used to define neighbourhood SES. Clinical assessments collected data on adiposity, blood pressure, blood glucose and blood lipids. Generalised additive mixed models were used to estimate associations.Results: Neighbourhood walkability showed indirect beneficial associations with most indicators of car-diometabolic health via resistance training, walking and sitting for different purposes; indirect detrimental as-sociations with the same indicators via vigorous gardening; and direct detrimental associations with blood pressure. The neighbourhood natural environment had beneficial indirect associations with most car-diometabolic health indicators via resistance training and leisure-time sitting, and beneficial direct associations with adiposity and blood lipids. Neighbourhood SES and air pollution moderated only a few associations of the neighbourhood environment with physical activity, blood lipids and blood pressure.Conclusions: Within a low-density and low-pollution context, denser, walkable neighbourhoods with good access to nature may benefit residents' cardiometabolic health by facilitating the adoption of an active lifestyle. Possible disadvantages of living in denser neighbourhoods for older populations are having limited opportunities for gardening, higher levels of noise and less healthy dietary patterns associated with eating out.
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页数:17
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