Adults in lower walkability neighborhoods found to have a higher predicted cardiovascular risk

October 31, 2019

A study led by researchers from St. Michael's Hospital of Unity Health Toronto and ICES found that people living in neighbourhoods considered to be the least walkable were up to 33 per cent more likely to have a high predicted 10-year cardiovascular risk compared to individuals living in the most walkable neighbourhoods.

The study, publishing on Oct. 31, 2019 in the Journal of the American Heart Association, is the first of its kind to analyze overall predicted risk over 10 years. The study analyzed nearly 45,000 individuals aged 40 to 74 living in 15 major urban centres in the Canadian province of Ontario.

In addition to a higher risk for cardiovascular disease, researchers also found that individuals living in the least walkable neighbourhoods had significantly higher blood pressure and higher odds of a prior diabetes diagnosis.

"The findings demonstrate that walkability is associated with clinically relevant differences in cardiovascular disease risk," said Dr. Nicholas Howell, first author of the study and a PhD graduate in the Li Ka Shing Knowledge Institute of St. Michael's. "From a public policy perspective, the findings support the idea that the benefits of walkable neighbourhoods could be significant enough to move the dial for individual health."

Dr. Gillian Booth, lead author of the study and a scientist at St. Michael's Hospital's MAP Centre for Urban Health Solutions, said previous research has also shown that the way cities and communities are designed can have a profound impact on our health.

"This research demonstrates that a future cardiovascular risk can be predicted based on the walkability of your residence," said Dr. Booth, who is also a senior adjunct scientist with ICES, the not-for-profit research institute where the Ontario data is held and analyzed.

"This research should be an encouragement for those living in less walkable neighbourhoods to source physical activities in other ways."

The study also found that living in a less walkable neighbourhood was associated with a lower likelihood of smoking, suggesting that the differences in predicted cardiovascular risk may be partially offset because of higher levels of smoking in more walkable neighbourhoods.
Funding sources: Dr Howell is supported by a Vanier Canada Graduate Scholarship from the Canadian Institutes for Health Research, a CIHR MD/PhD Studentship, a McLaughlin Centre MD/PhD Studentship, and a McLaughlin Centre Graduate Student Award. Dr Tu was supported by a Canada Research Chair in Health Services Research and an Eaton Scholar award from the Department of Medicine at the University of Toronto during the period of this research. Dr Booth is supported by a Clinician-Scientist Merit Award from the Department of Medicine at the University of Toronto. This study was funded by a Foundation Grant from CIHR (Dr Booth), and an Institute for Circulatory and Respiratory Health/CIHR Team Grant to the Cardiovascular HEalth in Ambulatory Care Research Team (CANHEART). This study was supported by ICES, which is funded by an annual grant from the Ontario MOHLTC. The opinions, results and conclusions reported in this paper are those of the authors and are independent from the funding sources. No endorsement by ICES or the Ontario MOHLTC is intended or should be inferred.

St. Michael's Hospital

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