Population cardiovascular health and urban environments: the Heart Healthy Hoods exploratory study in Madrid, Spain.
Population cardiovascular health and urban environments: the Heart Healthy Hoods exploratory study in Madrid, Spain.
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DOI：
10.1186/s12874-016-0213-4
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发表时间：
2016-08-22
影响因子：
4
通讯作者：
HHH Research Group
中科院分区：
文献类型：
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作者：
Bilal U;Díez J;Alfayate S;Gullón P;Del Cura I;Escobar F;Sandín M;Franco M;HHH Research Group
我们的目标是进行一项探索性研究，以提供与心血管健康相关的社区社会和物理环境的深入特征。采用混合方法更好地了解城市环境中的食物、酒精、烟草和身体活动领域。我们在西班牙马德里的一个有16,000名居民的地区进行了这项研究。我们使用马德里初级卫生保健系统的电子健康记录获得了所有45岁及以上居民的心血管健康和危险因素数据。我们使用了几种量化审计工具来评估：食品销售点和健康食品供应的类型和位置；烟草和酒精销售点；所有街道的步行能力以及公园和公共空间的使用情况。我们还对关键信息者进行了11次定性访谈，以帮助了解城市环境与心血管行为之间的关系。我们按照混合方法合并的方法整合了定量和定性数据。该地区所有人口的电子健康记录显示，与马德里/西班牙其他地区相比，风险因素的患病率相似(糖尿病患病率：12%，高血压：34.0%，血脂异常：32.0%，吸烟：10%，肥胖症：20%)。食物环境非常密集，有许多小商店(n = 44)和一个有112个摊位的大型食品市场。居民们强调了这些小商店对于购买健康食品的重要性。酒精和烟草环境也非常密集(分别为n = 91和)，主要是酒吧和餐馆(n = 53)，它们还提供食品服务。邻居们强调了饮酒作为一种社交机制的重要性。公共开放空间主要由老年人使用，这表明了进入这些空间和步行目的地的重要性。这一经验允许测试和改进来自流行病学、地理学、社会学和人类学的测量工具，以更好地了解与心血管健康相关的城市环境。本文的在线版本(doi：10.1186/s12874-0160213-4)包含补充材料，授权用户可以使用。
Our aim is to conduct an exploratory study to provide an in-depth characterization of a neighborhood’s social and physical environment in relation to cardiovascular health. A mixed-methods approach was used to better understand the food, alcohol, tobacco and physical activity domains of the urban environment. We conducted this study in an area of 16,000 residents in Madrid (Spain). We obtained cardiovascular health and risk factors data from all residents aged 45 and above using Electronic Health Records from the Madrid Primary Health Care System. We used several quantitative audit tools to assess: the type and location of food outlets and healthy food availability; tobacco and alcohol points of sale; walkability of all streets and use of parks and public spaces. We also conducted 11 qualitative interviews with key informants to help understanding the relationships between urban environment and cardiovascular behaviors. We integrated quantitative and qualitative data following a mixed-methods merging approach. Electronic Health Records of the entire population of the area showed similar prevalence of risk factors compared to the rest of Madrid/Spain (prevalence of diabetes: 12 %, hypertension: 34 %, dyslipidemia: 32 %, smoking: 10 %, obesity: 20 %). The food environment was very dense, with many small stores (n = 44) and a large food market with 112 stalls. Residents highlighted the importance of these small stores for buying healthy foods. Alcohol and tobacco environments were also very dense (n = 91 and 64, respectively), dominated by bars and restaurants (n = 53) that also acted as food services. Neighbors emphasized the importance of drinking as a socialization mechanism. Public open spaces were mostly used by seniors that remarked the importance of accessibility to these spaces and the availability of destinations to walk to. This experience allowed testing and refining measurement tools, drawn from epidemiology, geography, sociology and anthropology, to better understand the urban environment in relation to cardiovascular health. The online version of this article (doi:10.1186/s12874-016-0213-4) contains supplementary material, which is available to authorized users.