Introduction
Prior studies suggest that exposure to the natural environment may impact health.
The present study examines the association between objective measures of block-level
greenness (vegetative presence) and chronic medical conditions, including cardiometabolic
conditions, in a large population-based sample of Medicare beneficiaries in Miami-Dade
County, Florida.
Methods
The sample included 249,405 Medicare beneficiaries aged ≥65 years whose location (ZIP+4)
within Miami-Dade County, Florida, did not change, from 2010 to 2011. Data were obtained
in 2013 and multilevel analyses conducted in 2014 to examine relationships between
greenness, measured by mean Normalized Difference Vegetation Index from satellite
imagery at the Census block level, and chronic health conditions in 2011, adjusting
for neighborhood median household income, individual age, gender, race, and ethnicity.
Results
Higher greenness was significantly associated with better health, adjusting for covariates:
An increase in mean block-level Normalized Difference Vegetation Index from 1 SD less
to 1 SD more than the mean was associated with 49 fewer chronic conditions per 1,000
individuals, which is approximately similar to a reduction in age of the overall study
population by 3 years. This same level of increase in mean Normalized Difference Vegetation
Index was associated with a reduced risk of diabetes by 14%, hypertension by 13%,
and hyperlipidemia by 10%. Planned post-hoc analyses revealed stronger and more consistently
positive relationships between greenness and health in lower- than higher-income neighborhoods.
Conclusions
Greenness or vegetative presence may be effective in promoting health in older populations,
particularly in poor neighborhoods, possibly due to increased time outdoors, physical
activity, or stress mitigation.
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Article info
Publication history
Published online: April 06, 2016
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© 2016 American Journal of Preventive Medicine. Published by American Journal of Preventive Medicine All rights reserved.
