Interaction between neighborhood walkability and traffic-related air pollution on hypertension and diabetes: The CANHEART cohort

Living in unwalkable neighborhoods has been associated with heightened risk for diabetes and hypertension. However, highly walkable environments may have higher concentrations of traffic-related air pollution, which may contribute to increased cardiovascular disease risk. We therefore aimed to asses...

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Bibliographic Details
Published in:Environment international 2019-11, Vol.132, p.104799-104799, Article 104799
Main Authors: Howell, Nicholas A., Tu, Jack V., Moineddin, Rahim, Chen, Hong, Chu, Anna, Hystad, Perry, Booth, Gillian L.
Format: Article
Language:English
Subjects:
Adult
Aged
Air pollution
Cohort Studies
Cross-Sectional Studies
Diabetes
Diabetes Mellitus - etiology
Female
Humans
Hypertension
Hypertension - etiology
Logistic Models
Male
Middle Aged
NO2
Ontario
Residence Characteristics
Risk Factors
Traffic-Related Pollution - adverse effects
Walkability
Walking
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Summary:Living in unwalkable neighborhoods has been associated with heightened risk for diabetes and hypertension. However, highly walkable environments may have higher concentrations of traffic-related air pollution, which may contribute to increased cardiovascular disease risk. We therefore aimed to assess how walkability and traffic-related air pollution jointly affect risk for hypertension and diabetes. We used a cross-sectional, population-based sample of individuals aged 40–74 years residing in selected large urban centres in Ontario, Canada on January 1, 2008, assembled from administrative databases. Walkability and traffic-related air pollution (NO2) were assessed using validated tools and linked to individuals based on neighborhood of residence. Logistic regression was used to estimate adjusted associations between exposures and diagnoses of hypertension or diabetes accounting for potential confounders. Overall, 2,496,458 individuals were included in our analyses. Low walkability was associated with higher odds of hypertension (lowest vs. highest quintile OR = 1.34, 95% CI: 1.32, 1.37) and diabetes (lowest vs. highest quintile OR = 1.25, 95% CI: 1.22, 1.29), while NO2 exhibited similar trends (hypertension: OR = 1.09 per 10 p.p.b., 95% CI: 1.08, 1.10; diabetes: OR = 1.16, 95% CI: 1.14, 1.17). Significant interactions were identified between walkability and NO2 on risk for hypertension (p 
ISSN:0160-4120
1873-6750
DOI:10.1016/j.envint.2019.04.070