Researchers report that city living may slightly lower the risk of a first-time stroke. The study followed more than 25,000 adults across the United States and found a 2.5% lower risk in areas with medium or high development compared with less developed areas.
The team used data from REGARDS (REasons for Geographic And Racial Differences in Stroke), which studies health disparities in the "stroke belt," an 11-state region in the Southeastern US where stroke mortality is high among Black Americans, says Cathy Antonakos of the University of Michigan School of Kinesiology. Satellite data measured development intensity in 5-mile (8-km) road networks around more than 34,000 residential locations.
The link between higher development and lower stroke risk remained after adjustment for age, race, sex and health conditions such as diabetes and high blood pressure. Antonakos says the next step is to identify which environmental features explain the association. High-intensity development often brings greater housing density and retail, and can improve access to health care, stores, public transport and infrastructure for physical activity, but the study did not test these features directly.
The research appears in Cities & Health. Additional coauthors are from the University of Michigan, the University of Alabama at Birmingham, and the University of Cincinnati Academic Health Center. The work was supported by grant U01 NS041588 and funding from NIH institutes; computational resources were provided by Advanced Research Computing at the University of Michigan. The content is the authors' responsibility and does not necessarily represent official NIH views.
Difficult words
- development intensity — Measure of buildings, roads and human activity
- mortality — Number of deaths in a population
- satellite — Object in orbit that collects data
- adjustment — Change in analysis to control other factors
- infrastructure — Basic public systems like transport and services
- coauthor — Other researchers who contributed to the workcoauthors
- computational resources — Computer systems used for data processing
Tip: hover, focus or tap highlighted words in the article to see quick definitions while you read or listen.
Discussion questions
- What environmental features do you think might explain the lower stroke risk in more developed areas? Give reasons.
- How could access to health care and public transport affect people's health in cities compared with less developed areas?
- What are possible limitations of using satellite measures of development to study health outcomes like stroke?
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