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Residential urban greenspace and hypertension: A comparative study in two European cities
Mariska Bauwelinck Wilma L Zijlema Xavier Bartoll Hadewijch Vandenheede Marta Cirach Wouter Lefebvre Charlotte Vanpoucke Mark Nieuwenhuijsen Carme Borrell Patrick Deboosere
Mariska Bauwelinck
Wilma L Zijlema
Xavier Bartoll
Hadewijch Vandenheede
Marta Cirach
Wouter Lefebvre
Charlotte Vanpoucke
Mark Nieuwenhuijsen
Carme Borrell
Patrick Deboosere
Abstract
Background
Living in green areas has been associated with several health benefits; however, the available evidence on such benefits for hypertension is still limited. This study aimed to investigate and compare the association between residential exposure to greenspace and hypertension in Barcelona, Spain and Brussels, Belgium.
Methods
This cross-sectional study was based on data from the 2016 Barcelona Health Interview Survey (HIS) (n = 3400) and the 2013 Belgian HIS (n = 2335). Both surveys were harmonized in terms of outcomes, confounders and exposure assessment. Residential exposure to greenspace was characterized as 1) surrounding greenspace (normalized difference vegetation index (NDVI) and modified soil-adjusted vegetation index 2 (MSAVI2)) across buffers of 100 m, 300 m, and 500 m; 2) surrounding green space across 300 m and 500 m buffers; and 3) Euclidean distance to the nearest green space. Our outcome was self-reported hypertension. We developed logistic regression models to evaluate the city-specific association between each greenspace measure and hypertension, adjusting for relevant covariates.
Results
One interquartile range (IQR) increase in residential distance to the nearest green space was associated with higher risk of hypertension in Barcelona [odds ratio (OR): 1.15; 95%CI 1.03–1.29 (IQR: 262.2)], but not in Brussels [OR: 0.95; 95%CI 0.77–1.17 (IQR: 215.2)]. Stratified analyses suggested stronger associations in older participants (≥65 years) for both cities. Findings for residential surrounding green space and greenspace were not conclusive. However, in Brussels, we found protective associations in older participants for both residential surrounding greenspace metrics [NDVI 300 m buffer OR: 0.51; 95%CI 0.32–0.81 (IQR: 0.21) and MSAVI2 300 m buffer OR: 0.51; 95%CI 0.32–0.83 (IQR: 0.18)]. We did not find any indication for the modification of our evaluated associations by sex and education level.
Conclusion
Our study suggests that living closer to greenspace could be associated with lower risk of hypertension, particularly in older age. Future research is needed to replicate our findings in other settings and shed light on potential underlying mechanism(s).
Keywords
Natural environment, Green space, Health, Urban areas, High blood pressure
Date
2020
Type
Journal article
Journal
Environmental Research
Book
Volume
191
Issue
Page Range
1-9
Article Number
ACU Department
Mary MacKillop Institute for Health Research
Faculty of Health Sciences
Faculty of Health Sciences
Collections
Relation URI
Source URL
Event URL
Open Access Status
License
File Access
Controlled