Neighborhood walkability and residential greenness linked to Lower Fracture Risk: JAMA

In a recent study published in Journal of American Medical Association uncovered a significant connection between neighborhood walkability and residential greenness, and a lower risk of incident fractures among individuals aged 40 and older.

The study, which commenced in June 2015 and concluded in February 2023, sheds light on how the living environment may influence the bone health. A total of 23,940 participants, of which 57.4% were female, were closely observed during the study, which spanned 134,638 person-years. The mean age of participants at the outset of the study was 63.4 years.

The research, using the International Statistical Classification of Diseases and Related Health Problems, Tenth Revision codes via the Yinzhou Health Information System to identify incident fractures, unearthed compelling evidence. According to the findings, individuals residing in neighborhoods with greater walkability and residential greenness demonstrated a notably reduced risk of fractures.

In the fully adjusted model, for every interquartile range (IQR) increment in neighborhood walkability and residential greenness, there was a corresponding decrease in the hazard ratio (HR) for fracture risk. Specifically, an IQR increase in neighborhood walkability was associated with an HR of 0.88 (with a 95% confidence interval of 0.83-0.92), while residential greenness showed a similar pattern, with an HR of 0.84 (with a 95% confidence interval of 0.80-0.89).

Even more intriguingly, the study revealed a synergistic effect between walkability and greenness. In neighborhoods boasting the highest quartile of walkability, the risk of fracture was significantly lower. The HR for greenness in the top quartile of walkability neighborhoods was just 0.62 (with a 95% confidence interval of 0.46-0.82), suggesting that the benefits of green spaces are maximized in areas designed for pedestrian-friendly living.

These findings underscore the value of creating neighborhoods that promote walkability and provide access to green spaces, not only for physical activity but also for overall well-being. As our world becomes increasingly urbanized, this study offers valuable insights into how we can design cities and communities to support healthier, more active lives and reduce the risk of fractures among older adults.

Reference:

Zhu, Z., Yang, Z., Xu, L., Wu, Y., Yu, L., Shen, P., Lin, H., Shui, L., Tang, M., Jin, M., Wang, J., & Chen, K. (2023). Exposure to Neighborhood Walkability and Residential Greenness and Incident Fracture. In JAMA Network Open (Vol. 6, Issue 9, p. e2335154). American Medical Association (AMA). https://doi.org/10.1001/jamanetworkopen.2023.35154