HEARTHEALTHYHOODS · Social and Physical Urban Environment and Cardiovascular Health: The Much Needed Population Approach

Previous research has shown that the environments where we live and work have a major impact on our health. Given the economic and public health burden of cardiovascular diseases in Europe, we propose to measure specific aspects of the social and physical urban environment and to assess their contribution to cardiovascular risk. These results will provide the scientific evidence needed to develop population-wide preventive interventions.Specifically, for this project we will assess the food, physical activity and tobacco environments of 90 neighbourhoods in Madrid, Spain, using three complementary approaches: inhabitant perceptions, geographic information systems and systematic social observation. We will then correlate these data with cardiovascular health obtained from two different sources: first, a primary care-based cohort study including 2200 persons from 90 neighbourhoods, and second, a whole-population study including every inhabitant of the targeted neighbourhoods using primary care electronic health records (>99% coverage).The methodology of this proposal includes state-of-the-art qualitative and quantitative tools. We will combine ecometrics, geography, sociology and anthropology, to obtain a comprehensive description of the environments within which our population resides and works. In addition, the cohort study will include direct measures of cardiovascular health indicators, constituting a robust and multi-faceted source of data. The whole-population study offers the potential to have a complete portrait of the cardiovascular health of the 2.2 million inhabitants of our designated neighbourhoods. Cohort studies of this kind offer the opportunity for collaborative work, which can lead to a large and extended multidisciplinary scientific project.This proposal offers a novel way of understanding cardiovascular health by combining a social science perspective with high-quality cardiovascular data collection within a rigorous epidemiological design.