Abstract 13513: Favorable Neighborhood Walkability is Associated With Lower Burden of CV Risk Factors Among Patients Within an Integrated Health System: Houston Methodist CVD Learning Health System Registry
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Background: Optimizing modifiable cardiovascular risk factors is critical to achieving AHAs 2020 Strategic Impact Goals. Neighborhood and urban factors with a supportive walkable environment can enhance physical activity and hence impact CVH across a wide range of populations. We assessed whether a more walkable environment is associated with CV risk factor burden irrespective of CVD burden among a large diverse population within an integrated health system. Methods: Cross-sectional study using data from 1.01 million patients aged 18+ years in the Houston Methodist Cardiovascular Disease Learning Health System Registry (2016-2021). Individuals lacking NW (177,674) & BMI <18.5 kg/m 2 (27,065) were excluded. Neighborhood walkability (NW) was defined using 2019 Walk Score. Patients were assigned to 1 of 4 NW categories ( Figure ). Study participants were classified as poor (>3 CV risk factors), average (1-2 CV risk factors) or optimal (0 CV risk factors). Results: We included 901,860 patients (mean age 51.88, female 59%, NHB 15%, and 16% Hispanics), most of these (86%) resided in the 2 least walkable neighborhoods. Age-adjusted prevalence of CV risk factors was significantly lower among participants in most favorable walkable neighborhoods irrespective of CVD status ( Figure ). In adjusted analysis, favorable NW (somewhat/very walkable) vs unfavorable NW (car dependent) was associated with 2-fold odds for optimal vs poor CVD risk (OR 2.07 95%CI: 2.01-2.12) among those without CVD. Similar results were found in those with CVD (OR 1.58 95% CI:1.41-1.77). Conclusions: Our findings demonstrate favorable association between neighborhood walkability and the CVD risk factors burden in large population of about 1 million individuals. These robust findings support multilevel health system stakeholder engagements and investments in walkable neighborhoods as a viable tool for mitigating growing burden of modifiable CV risk factors.
