Type and Proximity of Green Spaces Are Important for Preventing Cardiovascular Morbidity and Diabetes—A Cross-Sectional Study for Quebec, Canada
Abstract
:1. Introduction
2. Methods and Data
2.1. Health Data
2.2. Green Space Data
- A GS with natural functions (provincial or national parks and woodlands).
- A GS with sport facilities (golf courses or any sport facilities).
- A GS used for fairs and other fun activities (any type of park, excluding provincial and national parks as well woodlands and GSes with sport facilities).
- A GS crossed by walking or cycling tracks (any type accessed and completely or partly crossed by walking or cycling tracks).
- A GS crossed by roads (any type accessed and completely or partly crossed by a road)
- A GS accessible by public transportation (bus or metro).
- A GS surface area illustrating its size.
- An additional variable considering the distance to any type of GS (regardless of its specificity, but only considering the presence of vegetation) was also analyzed.
2.3. Social and Demographic Predictors of Cardiovascular Diseases
2.4. Environmental Predictors of Cardiovascular Diseases
2.5. Analysis
- Empirical Bayesian standardized morbidity rates (SMR) maps of the statistically relevant CVD or their risk factors. The relevance was based on the significance of the relationship between GS and the CVD or their risk factors within the Poisson or negative binomial regression models. Bayesian analysis helps to better control the variance due to the discrepancies between total population sizes of the different DAs [42].
- The second input was the GS variables that were relevant in Poisson or negative binomial regressions models.
3. Results and Discussion
3.1. Results
3.2. Types of Green Spaces that Promote Vigorous Physical Activities May Be Important to Prevent Cardiovascular Diseases and Diabetes
3.3. Are Green Spaces’ Ecological Services Less Important than Social Services for Preventing Cardiovascular Diseases?
3.4. Implication for Public Health
3.5. Limitations of this Study
4. Conclusions
Acknowledgments
Author Contributions
Conflicts of Interest
References
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Outcomes | Age Standardized Rates and CI * | Variance | Crude Rates and CI * | Variance |
---|---|---|---|---|
Diabetes | 7.70 (7.67–7.73) | 0.00 | 8.78 (8.75–8.81) | 0.00 |
Ischemic heart diseases | 7.69 (7.66–7.71) | 0.00 | 9.27 (9.24–9.30) | 0.00 |
Cerebrovascular diseases | 2.16 (2.15–2.17) | 0.00 | 2.56 (2.54–2.58) | 0.00 |
Heart failure | 3.06 (3.04–3.08) | 0.00 | 3.51 (3.48–3.53) | 0.00 |
Montreal | ||||
Diabetes | 8.26 (8.20–8.31) | 0.00 | 9.10 (9.04–9.17) | 0.00 |
Ischemic heart diseases | 7.06 (7.01–7.11) | 0.00 | 8.46 (8.40–8.52) | 0.00 |
Cerebrovascular diseases | 2.07 (2.04–2.10) | 0.00 | 2.49 (2.46–2.52) | 0.00 |
Heart failure | 2.90 (2.86–2.5) | 0.00 | 3.66 (3.61–3.71) | 0.00 |
Quebec | ||||
Diabetes | 6.85 (6.76–6.93) | 0.00 | 8.21 (8.11–8.31) | 0.00 |
Ischemic heart diseases | 8.31 (8.22–8.40) | 0.00 | 10.58 (10.46–10.69) | 0.00 |
Cerebrovascular diseases | 1.79 (1.74–1.83) | 0.00 | 2.26 (2.20–2.31) | 0.00 |
Heart failure | 3.38 (3.31–3.46) | 0.00 | 4.13 (4.04–4.22) | 0.00 |
Explanatory Variables | Prevalence Rate Ratio | Standard Error | Z | p > z | 95% (Confidence Intervals) |
---|---|---|---|---|---|
Quartiles of mean distances to GSes with sports facilities | |||||
Q1 (Reference = 0.00–264.59 m) | |||||
Q2 (264.60–468.62 m) | 1.03 | 0.04 | 0.89 | 0.37 | 0.95–1.13 |
Q3 (468.63–774.42 m) | 1.07 | 0.04 | 1.69 | 0.09 | 0.98–1.17 |
Q4 (774.43–27,781.92 m) | 1.11 | 0.05 | 2.26 | 0.02 | 1.01–1.22 |
Social deprivation score * | |||||
Least deprived (reference) | |||||
Intermediate deprivation category | 1.04 | 0.04 | 1.01 | 0.31 | 0.96–1.12 |
Most deprived | 1.03 | 0.04 | 0.45 | 0.45 | 0.94–1.13 |
Material deprivation score * | |||||
Least deprived (reference) | |||||
Intermediate deprivation category | 0.97 | 0.03 | −0.74 | 0.46 | 0.90–1.04 |
Most deprived | 0.96 | 0.04 | −0.81 | 0.42 | 0.88–1.05 |
Quartiles of population density | |||||
Least dense (Reference = 1–2528 km2) | |||||
Intermediate 1 (2529–4028 km2 | 0.96 | 0.04 | 0.73 | 0.46 | 0.88–1.05 |
Intermediate 2 (4030–8805 km2 | 0.88 | 0.04 | −2.57 | 0.01 | 0.80–0.97 |
Densest (8807–125,463 km2) | 0.88 | 0.04 | −2.27 | 0.02 | 0.80–0.98 |
Quebec City CMA (in reference to Montreal CMA) | 0.86 | 0.03 | −3.25 | 0.00 | 0.79–0.94 |
Proportion of recent immigrants | 0.99 | 0.05 | −0.15 | 0.88 | 0.98–1.01 |
Distance to indoor sports centers (in km2) | 0.99 | 0.01 | −0.35 | 0.72 | 0.97–1.01 |
Distance to major roads (in Km2) | 1.06 | 0.06 | 0.96 | 0.33 | 0.93–1.20 |
Distance to industrial pollutants (in Km2) | 0.99 | 0.01 | −0.24 | 0.80 | 0.96–1.02 |
Explanatory Variables | Prevalence Rate Ratio | Standard Error | Z | p > z | 95% (Confidence Intervals) |
---|---|---|---|---|---|
Quartiles of mean distances to GSes with sports facilities | |||||
Q1 (Reference = 0.00–264.59 m) | |||||
Q2 (264.60–468.62 m) | 1.04 | 0.02 | 1.89 | 0.06 | 0.99–1.08 |
Q3 (468.63–774.42 m) | 1.02 | 0.02 | 1.35 | 0.17 | 0.98–1.07 |
Q4 (774.43–27,781.92 m) | 1.09 | 0.02 | 3.47 | 0.00 | 1.03–1.13 |
Social deprivation score * | |||||
Least deprived (reference) | - | ||||
Intermediate deprivation category | 1.00 | 0.01 | 0.13 | 0.89 | 0.96–1.03 |
Most deprived | 1.00 | 0.02 | 0.15 | 0.88 | 0.96–1.04 |
Material deprivation score * | |||||
Least deprived (reference) | |||||
Intermediate deprivation category | 0.99 | 0.01 | −0.42 | 0.67 | 0.95–1.02 |
Most deprived | 0.95 | 0.02 | −2.00 | 0.04 | 0.91–0.99 |
Quartiles of population density | |||||
Least dense (Reference = 1–2528 km2) | |||||
Intermediate 1 (2529–4028 km2 | 0.95 | 0.02 | −1.97 | 0.04 | 0.91–0.99 |
Intermediate 2 (4030–8805 km2) | 0.89 | 0.02 | −4.98 | 0.00 | 0.85–0.93 |
Densest (8807–125,463 km2) | 0.90 | 0.02 | −4.17 | 0.00 | 0.86–0.94 |
Quebec City CMA (in reference to Montreal CMA) | 0.95 | 0.01 | −2.42 | 0.91–0.99 | |
Rate of recent immigrants | 0.99 | 0.00 | −1.63 | 0.10 | 0.98–1.00 |
Distance to indoor sports centers (in km2) | 1.00 | 0.00 | 2.37 | 0.02 | 0.99–1.01 |
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Ngom, R.; Gosselin, P.; Blais, C.; Rochette, L. Type and Proximity of Green Spaces Are Important for Preventing Cardiovascular Morbidity and Diabetes—A Cross-Sectional Study for Quebec, Canada. Int. J. Environ. Res. Public Health 2016, 13, 423. https://doi.org/10.3390/ijerph13040423
Ngom R, Gosselin P, Blais C, Rochette L. Type and Proximity of Green Spaces Are Important for Preventing Cardiovascular Morbidity and Diabetes—A Cross-Sectional Study for Quebec, Canada. International Journal of Environmental Research and Public Health. 2016; 13(4):423. https://doi.org/10.3390/ijerph13040423
Chicago/Turabian StyleNgom, Roland, Pierre Gosselin, Claudia Blais, and Louis Rochette. 2016. "Type and Proximity of Green Spaces Are Important for Preventing Cardiovascular Morbidity and Diabetes—A Cross-Sectional Study for Quebec, Canada" International Journal of Environmental Research and Public Health 13, no. 4: 423. https://doi.org/10.3390/ijerph13040423