The Relationship Between Urban Sprawl and Coronary Heart Disease in Women

Published in: Health & Place, v. 20, Mar. 2013, p. 51-61

Posted on RAND.org on March 01, 2013

by Beth Ann Griffin, Christine Eibner, Chloe E. Bird, Adria D. Jewell, Karen L Margolis, Regina A. Shih, Mary Ellen Slaughter, Eric A Whitsel, Matthew Allison, Jose J. Escarce

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Studies have reported relationships between urban sprawl, physical activity, and obesity, but – to date – no studies have considered the relationship between sprawl and coronary heart disease (CHD) endpoints. In this analysis, we use longitudinal data on post-menopausal women from the Women's Health Initiative (WHI) Clinical Trial to analyze the relationship between metropolitan statistical area (MSA)-level urban compactness (the opposite of sprawl) and CHD endpoints including death, any CHD event, and myocardial infarction. Models control for individual and neighborhood socio-demographic characteristics. Women who lived in more compact communities at baseline had a lower probability of experiencing a CHD event and CHD death or MI during the study follow-up period. One component of compactness, high residential density, had a particularly noteworthy effect on outcomes. Finally, exploratory analyses showed evidence that the effects of compactness were moderated by race and region.

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