The effect of street walking environment on the risk of hospitalization for ischemic heart disease among the elderly in Wuhan
Objective To quantitatively evaluate the relationship between street walking environment and the risk of hospitalization for ischemic heart disease(IHD)among the elderly in Wuhan,and provide the basis for developing the targeted prevention strategies for IHD.Methods The data of all inpatients with IHD and urban and rural planning data in Wuhan from January 1,2017 to December 31,2018 were collected;and 61 479 elderly inpatients with IHD in 178 streets of Wuhan were included.The indicators of street walking environment,such as roadway density,intersection density,plot ratio,point of interest(POI)density,POI diversity,destination accessibility,normalized difference vegetation index(NDVI)and land use type were calculated.Poisson regression analysis was used to analyze the effect of road factors on the risk of IHD hospitalization,the used software was R 4.1.3.Results The mean age of 61 479 older inpatients with IHD was(75.7±8.8)years old.The average hospitalization rate of IHD for two years in elderly residents of Wuhan was 3.84％(male:4.11％and female:3.57％).The patients with chronic IHD were 28 320 cases(46.1％),the patients with angina pectoris were 24 190 cases(39.3％),the patients with acute myocardial infarction were 6 861 cases(11.2％),the patients with other acute IHD were 1 986 cases(3.2％),the patients with complications of acute myocardial infarction were 82 cases(1.3％o),the patients with concomitant myocardial infarction were 40 cases(0.7％o).Poisson regression analysis showed that high roadway density(β=0.013,95％CI:0.009-0.017),high plot ratio(β=0.127,95％CI:0.001-0.243),high catering and entertainment POI density(β=0.001,95％CI:0.001-0.002)corrlated with high risk of hospitalization for elderly residents with IHD;high intersection density(β=-0.001,95％CI:-0.001--0.001),high healthcare POI density(β=-0.005,95％CI:-0.006--0.004),good park accessibility(β=-0.001,95％CI:-0.002--0.001),high NDVI(β=-0.121,95％CI:-0.165--0.078),and land use type:industrial use(β=-0.031,95％CI:-0.062--0.000)or public management use(β=-0.065,95％CI:-0.117--0.014)corrlated with low risk of hospitalization for elderly residents with IHD.High roadway density(β=0.019),high surrounding floor area ratio(β=0.184)and high catering and entertainment service POI density(β=0.001)corrlated with high risk of hospitalization for male residents with IHD;high surrounding floor area ratio(β=0.048)and high catering and entertainment service POI density(β=0.001)corrlated with high risk of hospitalization for female residents with IHD.The high roadway density(β=0.006)corrlated with high risk of hospitalization for angina pectoris;high roadway density(β=0.001)and healthcare POI density(β=0.000)corrlated with high risk of hospitalization for acute myocardial infarction;high roadway density(β=0.008),high plot ratio(β=0.071)and high life service POI density(β=0.001)correlated with high risk of hospitalization for chronic IHD;high roadway density(β=0.018)and high life service POI density(β=0.001)correlated with high risk of hospitalization for elderly IHD with circulation system disease;P＜0.05.Conclusion Street walking environment correlates with the risk of hospitalization for IHD in older adults.Excessively road density is associated with increased risk of IHD hospitalization.It should pay attention to the design of walking environment planning to facilitate daily walking of older adults for reducing the risk of IHD hospitalization.
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万方数据
