Diez Roux AV. Residential environments and cardiovascular risk. Journal of Urban Health: Bulletin of the New York Academy of Medicine. 2003;80:569-589.
This review article presents the rationale for studying the relationship between residential environments and cardiovascular health. In the first research area discussed, neighborhood socioeconomic characteristics and cardiovascular disease, the author notes that three studies have linked socioeconomically disadvantaged neighborhoods to a higher prevalence of coronary heart disease; two studies have linked neighborhood disadvantage to higher cardiovascular disease (CVD) mortality; and one study has linked neighborhood disadvantage to greater incidence of CVD. Five studies have linked neighborhood disadvantage to smoking, diet, blood pressure, blood lipids, and body mass index. In the second area of research, the effects of residential environments on physical activity, 19 quantitative studies have assessed the relationship between perceived and objectively determined attributes of the physical environment and physical activity behavior. The most consistent evidence regarding effects of environmental factors on physical activity in adults is observed for accessibility of facilities, opportunities for activity, and aesthetic qualities of an area. The author comments that this literature is limited in its conceptualization and measurement of environmental features since measures are neither objective nor validated. In a third area of research, the effects of residential environments on diet, it appears there has been little research relating specific features of the local food environment to the actual dietary behaviors of individuals. The author found no studies that examine changes in diet as a response to local changes in food availability or cost. The author calls for longitudinal studies with more direct observation of local environments.
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