Moving to a Highly Walkable Neighborhood and Incidence of Hypertension: A Propensity-Score Matched Cohort Study

• Published in: Environmental health perspectives 2016-06, Vol.124 (6), p.754-760
• Main Authors: Chiu, Maria, Rezai, Mohammad-Reza, Maclagan, Laura C, Austin, Peter C, Shah, Baiju R, Redelmeier, Donald A, Tu, Jack V
• Format: Article
• Language: English
• Subjects: Body mass index; Codes; Cohort analysis; Cohort Studies; Environment Design; Exercise; Geography; Health Surveys; Hospitals; Humans; Hypertension; Hypertension - epidemiology; Incidence; Land use; Marital status; Neighborhoods; Noncitizens; Ontario - epidemiology; Population; Postal codes; Public health; Residence Characteristics - statistics & numerical data; Rural areas; Sociodemographics; Socioeconomic Factors; Surveys and Questionnaires; Walking
• ISSN: 0091-6765; 1552-9924
• DOI: 10.1289/ehp.1510425

The impact of moving to a neighborhood more conducive to utilitarian walking on the risk of incident hypertension is uncertain. Our study aimed to examine the effect of moving to a highly walkable neighborhood on the risk of incident hypertension. A population-based propensity-score matched cohort study design was used based on the Ontario population from the Canadian Community Health Survey (2001-2010). Participants were adults ≥ 20 years of age who moved from a low-walkability neighborhood (defined as any neighborhood with a Walk Score < 90) to either a high- (Walk Score ≥ 90) or another low-walkability neighborhood. The incidence of hypertension was assessed by linking the cohort to administrative health databases using a validated algorithm. Propensity-score matched Cox proportional hazard models were used. Annual health examination was used as a control event. Among the 1,057 propensity-score matched pairs there was a significantly lower risk of incident hypertension in the low to high vs. the low to low-walkability groups [hazard ratio = 0.46; 95% CI, 0.26, 0.81, p < 0.01]. The crude hypertension incidence rates were 18.0 per 1,000 person-years (95% CI: 11.6, 24.8) among the low- to low-walkability movers compared with 8.6 per 1,000 person-years (95% CI: 5.3, 12.7) among the low- to high-walkability movers (p < 0.001). There were no significant differences in the hazard of annual health examination between the two mover groups. Moving to a highly walkable neighborhood was associated with a significantly lower risk of incident hypertension. Future research should assess whether specific attributes of walkable neighborhoods (e.g., amenities, density, land-use mix) may be driving this relationship. Chiu M, Rezai MR, Maclagan LC, Austin PC, Shah BR, Redelmeier DA, Tu JV. 2016. Moving to a highly walkable neighborhood and incidence of hypertension: a propensity-score matched cohort study. Environ Health Perspect 124:754-760; http://dx.doi.org/10.1289/ehp.1510425.