Association between greenness and cardiovascular risk factors: Results from a large cohort study in Thailand
Issued Date
2023-03-01
Resource Type
ISSN
00139351
eISSN
10960953
Scopus ID
2-s2.0-85145839215
Pubmed ID
36610535
Journal Title
Environmental Research
Volume
220
Rights Holder(s)
SCOPUS
Bibliographic Citation
Environmental Research Vol.220 (2023)
Suggested Citation
Paoin K., Pharino C., Phosri A., Ueda K., Seposo X.T., Kelly M., Seubsman S.a., Sleigh A. Association between greenness and cardiovascular risk factors: Results from a large cohort study in Thailand. Environmental Research Vol.220 (2023). doi:10.1016/j.envres.2023.115215 Retrieved from: https://repository.li.mahidol.ac.th/handle/123456789/81514
Title
Association between greenness and cardiovascular risk factors: Results from a large cohort study in Thailand
Other Contributor(s)
Abstract
Background: The risk of cardiovascular diseases may be reduced by residing in green environments. However, there are relatively few longitudinal cohort studies, especially in Southeast Asia, that focused on the health benefits of long-term greenness exposure in young adults. The present study examined the association between long-term exposure to residential greenness and self-reported morbidities in participants of the Thai Cohort Study (TCS) in Thailand from 2005 to 2013. Methods: The self-reported outcomes, including high blood pressure, high blood cholesterol, and diabetes, were reported in 2005, 2009, and 2013, where the study participants provided the exact year of disease occurrence. Greenness was assessed by the satellite-based Normalized Difference Vegetation Index (NDVI) and Enhanced Vegetation Index (EVI), with a spatial resolution of 250 m. Long-term exposure to NDVI and EVI of each participant's sub-district was averaged over the period of person-time. We used Cox proportional hazards models to examine the association between greenness and health outcomes. Associations with self-reported morbidity were measured using hazard ratios (HRs) per interquartile range (IQR) increase in NDVI and EVI. Results: After adjusting for potential confounders, we observed that an IQR increase in NDVI was associated with lower incidence of high blood pressure (HR = 0.92, 95% CI: 0.89, 0.97) and high blood cholesterol (HR = 0.89, 95%CI: 0.87, 0.92), but not significantly associated with diabetes (HR = 0.93, 95%CI: 0.85, 1.01). EVI was also inversely associated with self-reported high blood pressure (HR = 0.92, 95%CI: 0.88, 0.96), high blood cholesterol (HR = 0.89, 95%CI: 0.87, 0.91), and diabetes (HR = 0.92, 95%CI: 0.85, 0.99). Conclusions: Long-term exposure to residential greenness was inversely associated with self-reported high blood pressure, high blood cholesterol, and diabetes in participants of TCS. Our study provides evidence that greenness exposure may reduce cardiovascular disease risk factors in adult population.