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Neighbourhood Environment and Stroke: A Follow-Up Study in Sweden

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  • Tsuyoshi Hamano
  • Naomi Kawakami
  • Xinjun Li
  • Kristina Sundquist

Abstract

Background: In recent years, research on the association between physical environments and cardiovascular disease outcomes has gained momentum with growing attention being paid to Geographic Information Systems (GIS). This nationwide study is the first to examine the effect of neighbourhood physical environments on individual-level stroke, using GIS-based measures of neighbourhood availability of potentially health-damaging (fast food restaurants and pubs/bars) and health-promoting (physical activity and healthcare) resources. Methods: The study population comprised a nationwide sample of 2,115,974 men and 2,193,700 women aged 35–80 years who were followed between 1 December 2005 and 31 December 2007 in Sweden. Totally 42,270 first-ever strokes (both morbidity and mortality) were identified. Multilevel logistic regression models were used to estimate the association between neighbourhood availability of four different resources (fast food restaurants, pubs/bars, physical activity and healthcare) and individual-level stroke. Principal Findings: There were significant associations between neighbourhood availability of the four types of neighbourhood resources and individual-level stroke. The significant odds ratios varied between 1.06 and 1.12 for men and 1.07 and 1.24 for women. After adjustment for age, income, and neighbourhood-level deprivation, the increased odds remained statistically significant for neighbourhood availability of fast food restaurants in both men and women. Conclusions: Specific neighbourhood availability of resources were associated with individual-level stroke but most of these associations were explained by individual-level sociodemographic factors and neighbourhood-level deprivation.

Suggested Citation

  • Tsuyoshi Hamano & Naomi Kawakami & Xinjun Li & Kristina Sundquist, 2013. "Neighbourhood Environment and Stroke: A Follow-Up Study in Sweden," PLOS ONE, Public Library of Science, vol. 8(2), pages 1-6, February.
    • Handle: RePEc:plo:pone00:0056680
    DOI: 10.1371/journal.pone.0056680
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    References listed on IDEAS

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    1. Sundquist, Jan & Johansson, Sven-Erik & Yang, Min & Sundquist, Kristina, 2006. "Low linking social capital as a predictor of coronary heart disease in Sweden: A cohort study of 2.8 million people," Social Science & Medicine, Elsevier, vol. 62(4), pages 954-963, February.
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