Journal
ENVIRONMENTAL HEALTH PERSPECTIVES
Volume 124, Issue 6, Pages 754-760Publisher
US DEPT HEALTH HUMAN SCIENCES PUBLIC HEALTH SCIENCE
DOI: 10.1289/ehp.1510425
Keywords
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Funding
- Canadian Institutes of Health Research (CIHR)
- Heart and Stroke Foundation of Ontario
- CIHR New Investigator Award
- Canada Research Chair in Medical Decision Science
- CIHR grant from the CIHR
- Canada Research Chair in Health Services Research from the CIHR
- Institute for Circulatory Health-Canadian Institutes of Health Research Chronic Diseases Team grant [TCA 118349]
- Institute for Clinical Evaluative Sciences (ICES)
- Ontario Ministry of Health and Long-Term Care (MOHLTC)
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BACKGROUND: The impact of moving to a neighborhood more conducive to utilitarian walking on the risk of incident hypertension is uncertain. OBJECTIVE: Our study aimed to examine the effect of moving to a highly walkable neighborhood on the risk of incident hypertension. METHODS: 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. RESULTS: 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. CONCLUSIONS: 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.
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