Department of Nursing, Kkottongnae University, Cheongju 28211, Korea.
Department of Mathematics, Hanyang University, Seoul 04763, Korea.
Int J Environ Res Public Health. 2021 Feb 14;18(4):1861. doi: 10.3390/ijerph18041861.
This study assesses the association between the objectively measured built environment and cardiovascular diseases (CVDs) in 50,741 adults from the Korean Community Health Survey. The CVD outcomes of hypertension, diabetes, dyslipidemia, stroke, and myocardial infarction (MI) or angina were derived from self-reported histories of physician diagnoses. Using ArcGIS software and Korean government databases, this study measured the built environment variables for the 546 administrative areas of Gyeonggi province. A Bayesian spatial multilevel model was performed independently in two age groups (i.e., 40-59 years or ≥60 years). After adjusting for statistical significant individual- and community-level factors with the spatial associations, living far from public transit was associated with an increase in the odds of MI or angina in middle-aged adults, while living in neighborhoods in which fast-food restaurants were concentrated was associated with a decrease in the odds of hypertension and stroke. For adults 60 or older, living farther from public physical-activity (PA) facilities was associated with a 15% increased odds for dyslipidemia, compared with living in neighborhoods nearer to PA facilities. These findings suggest that creating a built environment that provides more opportunities to engage in PA in everyday life should be considered a strategy to reduce the prevalence of CVD.
本研究评估了在韩国社区健康调查中，50741 名成年人的客观测量的建成环境与心血管疾病（CVD）之间的关联。高血压、糖尿病、血脂异常、中风、心肌梗死（MI）或心绞痛的 CVD 结局来自于医生诊断的自我报告病史。本研究使用 ArcGIS 软件和韩国政府数据库，测量了京畿道 546 个行政区域的建成环境变量。在两个年龄组（即 40-59 岁或≥60 岁）中分别进行了贝叶斯空间多层次模型分析。在调整了具有空间关联的个体和社区水平因素的统计学意义后，远离公共交通与中年成年人患 MI 或心绞痛的几率增加有关，而居住在快餐餐厅集中的社区与高血压和中风的几率降低有关。对于 60 岁或以上的成年人，与居住在靠近体育锻炼（PA）设施的社区相比，居住在远离公共 PA 设施的地方，患血脂异常的几率增加了 15%。这些发现表明，创造一个提供更多日常参与 PA 机会的建成环境，应该被视为降低 CVD 患病率的一种策略。
