Urban greenness and mortality in Canada's largest cities: a national cohort study
Background: Findings from published studies suggest that exposure to and interactions with green spaces are associated with improved psychological wellbeing and have cognitive, physiological, and social benefits, but few studies have examined their potential effect on the risk of mortality. We there...
| Main Authors: | , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
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Elsevier
2017-10-01
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| Series: | The Lancet Planetary Health |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S2542519617301183 |
| _version_ | 1818451335880638464 |
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| author | Dr Dan L Crouse, PhD Lauren Pinault, PhD Adele Balram, MPH Perry Hystad, PhD Paul A Peters, PhD Hong Chen, PhD Aaron van Donkelaar, PhD Randall V Martin, PhD Richard Ménard, PhD Alain Robichaud, MSc Paul J Villeneuve, PhD |
| author_facet | Dr Dan L Crouse, PhD Lauren Pinault, PhD Adele Balram, MPH Perry Hystad, PhD Paul A Peters, PhD Hong Chen, PhD Aaron van Donkelaar, PhD Randall V Martin, PhD Richard Ménard, PhD Alain Robichaud, MSc Paul J Villeneuve, PhD |
| author_sort | Dr Dan L Crouse, PhD |
| collection | DOAJ |
| description | Background: Findings from published studies suggest that exposure to and interactions with green spaces are associated with improved psychological wellbeing and have cognitive, physiological, and social benefits, but few studies have examined their potential effect on the risk of mortality. We therefore undertook a national study in Canada to examine associations between urban greenness and cause-specific mortality.
Methods: We used data from a large cohort study (the 2001 Canadian Census Health and Environment Cohort [2001 CanCHEC]), which consisted of approximately 1·3 million adult (aged ≥19 years), non-immigrant, urban Canadians in 30 cities who responded to the mandatory 2001 Statistics Canada long-form census. The cohort has been linked by Statistics Canada to the Canadian mortality database and to annual income tax filings through 2011. We measured greenness with images from the moderate-resolution imaging spectroradiometer from NASA's Aqua satellite. We assigned estimates of exposure to greenness derived from remotely sensed Normalized Difference Vegetation Index (NDVI) within both 250 m and 500 m of participants' residences for each year during 11 years of follow-up (between 2001 and 2011). We used Cox proportional hazards models to estimate associations between residential greenness (as a continuous variable) and mortality. We estimated hazard ratios (HRs) and corresponding 95% CIs per IQR (0·15) increase in NDVI adjusted for personal (eg, education and income) and contextual covariates, including exposures to fine particulate matter, ozone, and nitrogen dioxide. We also considered effect modification by selected personal covariates (age, sex, household income adequacy quintiles, highest level of education, and marital status).
Findings: Our cohort consisted of approximately 1 265 000 individuals at baseline who contributed 11 523 770 person-years. We showed significant decreased risks of mortality in the range of 8–12% from all causes of death examined with increased greenness around participants' residence. In the fully adjusted analyses, the risk was significantly decreased for all causes of death (non-accidental HR 0·915, 95% CI 0·905–0·924; cardiovascular plus diabetes 0·911, 0·895–0·928; cardiovascular 0·911, 0·894–0·928; ischaemic heart disease 0·904, 0·882–0·927; cerebrovascular 0·942, 0·902–0·983; and respiratory 0·899, 0·869–0·930). Greenness associations were more protective among men than women (HR 0·880, 95% CI 0·868–0·893 vs 0·955, 0·941–0·969), and among individuals with higher incomes (highest quintile 0·812, 0·791–0·834 vs lowest quintile 0·991, 0·972–1·011) and more education (degree or more 0·816, 0·791–0·842 vs did not complete high school 0·964, 0·950–0·978).
Interpretation: Increased amounts of residential greenness were associated with reduced risks of dying from several common causes of death among urban Canadians. We identified evidence of inequalities, both in terms of exposures to greenness and mortality risks, by personal socioeconomic status among individuals living in generally similar environments, and with reasonably similar access to health care and other social services. The findings support the development of policies related to creating greener and healthier cities.
Funding: None. |
| first_indexed | 2024-12-14T21:05:34Z |
| format | Article |
| id | doaj.art-8de751fb879f4fbd9b520ea42991f920 |
| institution | Directory Open Access Journal |
| issn | 2542-5196 |
| language | English |
| last_indexed | 2024-12-14T21:05:34Z |
| publishDate | 2017-10-01 |
| publisher | Elsevier |
| record_format | Article |
| series | The Lancet Planetary Health |
| spelling | doaj.art-8de751fb879f4fbd9b520ea42991f9202022-12-21T22:47:29ZengElsevierThe Lancet Planetary Health2542-51962017-10-0117e289e29710.1016/S2542-5196(17)30118-3Urban greenness and mortality in Canada's largest cities: a national cohort studyDr Dan L Crouse, PhD0Lauren Pinault, PhD1Adele Balram, MPH2Perry Hystad, PhD3Paul A Peters, PhD4Hong Chen, PhD5Aaron van Donkelaar, PhD6Randall V Martin, PhD7Richard Ménard, PhD8Alain Robichaud, MSc9Paul J Villeneuve, PhD10Department of Sociology, University of New Brunswick, Fredericton, NB, CanadaHealth Analysis Division, Statistics Canada, Ottawa, ON, CanadaNew Brunswick Institute for Research, Data, and Training, Fredericton, NB, CanadaCollege of Public Health & Human Sciences, Oregon State University, Corvallis, OR, USANew Brunswick Institute for Research, Data, and Training, Fredericton, NB, CanadaPublic Health Ontario, Toronto, ON, CanadaDepartment of Physics & Atmospheric Science, Dalhousie University, Halifax, NS, CanadaDepartment of Physics & Atmospheric Science, Dalhousie University, Halifax, NS, CanadaAir Quality Research Division, Environment and Climate Change Canada, Dorval, QC, CanadaAir Quality Research Division, Environment and Climate Change Canada, Dorval, QC, CanadaDepartment of Health Sciences, Carleton University, Ottawa, ON, CanadaBackground: Findings from published studies suggest that exposure to and interactions with green spaces are associated with improved psychological wellbeing and have cognitive, physiological, and social benefits, but few studies have examined their potential effect on the risk of mortality. We therefore undertook a national study in Canada to examine associations between urban greenness and cause-specific mortality. Methods: We used data from a large cohort study (the 2001 Canadian Census Health and Environment Cohort [2001 CanCHEC]), which consisted of approximately 1·3 million adult (aged ≥19 years), non-immigrant, urban Canadians in 30 cities who responded to the mandatory 2001 Statistics Canada long-form census. The cohort has been linked by Statistics Canada to the Canadian mortality database and to annual income tax filings through 2011. We measured greenness with images from the moderate-resolution imaging spectroradiometer from NASA's Aqua satellite. We assigned estimates of exposure to greenness derived from remotely sensed Normalized Difference Vegetation Index (NDVI) within both 250 m and 500 m of participants' residences for each year during 11 years of follow-up (between 2001 and 2011). We used Cox proportional hazards models to estimate associations between residential greenness (as a continuous variable) and mortality. We estimated hazard ratios (HRs) and corresponding 95% CIs per IQR (0·15) increase in NDVI adjusted for personal (eg, education and income) and contextual covariates, including exposures to fine particulate matter, ozone, and nitrogen dioxide. We also considered effect modification by selected personal covariates (age, sex, household income adequacy quintiles, highest level of education, and marital status). Findings: Our cohort consisted of approximately 1 265 000 individuals at baseline who contributed 11 523 770 person-years. We showed significant decreased risks of mortality in the range of 8–12% from all causes of death examined with increased greenness around participants' residence. In the fully adjusted analyses, the risk was significantly decreased for all causes of death (non-accidental HR 0·915, 95% CI 0·905–0·924; cardiovascular plus diabetes 0·911, 0·895–0·928; cardiovascular 0·911, 0·894–0·928; ischaemic heart disease 0·904, 0·882–0·927; cerebrovascular 0·942, 0·902–0·983; and respiratory 0·899, 0·869–0·930). Greenness associations were more protective among men than women (HR 0·880, 95% CI 0·868–0·893 vs 0·955, 0·941–0·969), and among individuals with higher incomes (highest quintile 0·812, 0·791–0·834 vs lowest quintile 0·991, 0·972–1·011) and more education (degree or more 0·816, 0·791–0·842 vs did not complete high school 0·964, 0·950–0·978). Interpretation: Increased amounts of residential greenness were associated with reduced risks of dying from several common causes of death among urban Canadians. We identified evidence of inequalities, both in terms of exposures to greenness and mortality risks, by personal socioeconomic status among individuals living in generally similar environments, and with reasonably similar access to health care and other social services. The findings support the development of policies related to creating greener and healthier cities. Funding: None.http://www.sciencedirect.com/science/article/pii/S2542519617301183 |
| spellingShingle | Dr Dan L Crouse, PhD Lauren Pinault, PhD Adele Balram, MPH Perry Hystad, PhD Paul A Peters, PhD Hong Chen, PhD Aaron van Donkelaar, PhD Randall V Martin, PhD Richard Ménard, PhD Alain Robichaud, MSc Paul J Villeneuve, PhD Urban greenness and mortality in Canada's largest cities: a national cohort study The Lancet Planetary Health |
| title | Urban greenness and mortality in Canada's largest cities: a national cohort study |
| title_full | Urban greenness and mortality in Canada's largest cities: a national cohort study |
| title_fullStr | Urban greenness and mortality in Canada's largest cities: a national cohort study |
| title_full_unstemmed | Urban greenness and mortality in Canada's largest cities: a national cohort study |
| title_short | Urban greenness and mortality in Canada's largest cities: a national cohort study |
| title_sort | urban greenness and mortality in canada s largest cities a national cohort study |
| url | http://www.sciencedirect.com/science/article/pii/S2542519617301183 |
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