Density of Green Spaces and Cardiovascular Risk Factors in the City of Madrid: The Heart Healthy Hoods Study
Public Health and Epidemiology Research Group, School of Medicine, Universidad de Alcala, 28871 Madrid, Spain
Servicio de Medicina Preventiva y Gestión de Calidad, Hospital General Universitario Gregorio Marañón, 28007 Madrid, Spain
Urban Health Collaborative, Drexel Dornsife School of Public Health, Philadelphia, PA 19104, USA
Servicio de Medicina Preventiva, Hospital Universitario Infanta Leonor, 28031 Madrid, Spain
ISGlobal, Center for Research in Environmental Epidemiology (CREAL), 08036 Barcelona, Spain
Department of Biomedicine, Universitat Pompeu Fabra (UPF), 08002 Barcelona, Spain
Centro de Investigación Biomédica en Red de Epidemiología y Salud Pública (CIBERESP), 28029 Madrid, Spain
Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD 21205, USA
Author to whom correspondence should be addressed.
These authors contributed equally to this work.
Int. J. Environ. Res. Public Health 2019, 16(24), 4918; https://doi.org/10.3390/ijerph16244918
Received: 29 October 2019 / Revised: 30 November 2019 / Accepted: 3 December 2019 / Published: 5 December 2019
(This article belongs to the Special Issue Healing Spaces: Designing Physical Environments to Optimize Health, Wellbeing and Performance)
The aim of this study is to evaluate the relationship between the density of green spaces at different buffer sizes (300, 500, 1000 and 1500 m) and cardiovascular risk factors (obesity, hypertension, high cholesterol, and diabetes) as well as to study if the relationship is different for males and females. We conducted cross-sectional analyses using the baseline measures of the Heart Healthy Hoods study (N = 1625). We obtained data on the outcomes from clinical diagnoses, as well as anthropometric and blood sample measures. Exposure data on green spaces density at different buffer sizes were derived from the land cover distribution map of Madrid. Results showed an association between the density of green spaces within 300 and 500 m buffers with high cholesterol and diabetes, and an association between the density of green spaces within 1500 m buffer with hypertension. However, all of these associations were significant only in women. Study results, along with other evidence, may help policy-makers creating healthier environments that could reduce cardiovascular disease burden and reduce gender health inequities. Further research should investigate the specific mechanisms behind the differences by gender and buffer size of the relationship between green spaces and cardiovascular risk factors.