Your state of health depends on where you stay : study

The location you are residing at present may play an important risk factor for developing major diseases like cardiovascular disease, diabetes, and cancer. Sounds little weird but that is true.

The findings published in the journal Cities and Health has revealed that researchers at McMaster University have identified trends linking health and lifestyle factors like access to public transit, the variety of fresh fruits and vegetables in grocery stores, the prices of popular foods, the availability and prices of cigarettes and alcohol, and the promotion, or lack thereof, of healthy foods in restaurants.

This study is unique because it will enable comparisons between communities within a region, province, and across the country. Place matters as our environment affect our health behaviors without our realizing it.

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“We found there are significant differences in environmental factors that may contribute to health, and that these differed between urban and rural communities, as well as when we compared eastern with western, and northern with southern communities,” said Russell de Souza, first author of the study and assistant professor in the Department of Health Research Methods, Evidence, and Impact at McMaster.

The study was a component of the Canadian Alliance for Healthy Hearts and Minds (CAHHM), led by Sonia Anand, professor of medicine at McMaster, senior scientist of PHRI, and vascular medicine specialist at Hamilton Health Sciences.

CAHHM is a multi-ethnic cohort study being conducted in Canada. The study aims to understand the association of socio-environmental and contextual factors, such as societal structure, activity, nutrition, social and tobacco environments, and access to health services, in relation to risk factors of cardiovascular and other chronic diseases.

More than 2,000 on-the-ground assessments conducted in all of the provinces were collected by trained auditors between 2014 and 2016. The assessment tool was adapted from the McMaster-led Prospective Urban and Rural Epidemiological (PURE) study that simultaneously assesses multiple contextual factors within communities and has been used internationally.

The main findings of the study are:

• provincial and urban-rural differences exist in the availability of fruits and vegetables, and advertising differs between provinces more so than between urban and rural communities;


• rural communities face higher food prices, are more subject to seasonal variation in fruit and vegetable selection, and generally see less promotion of healthy restaurant options and availability of nutritional information at restaurants than urban communities;


• in-store advertising for sweet drinks and junk food are more frequent than in-store advertisements for tobacco products;


• cigarette prices are lower and the variety of brands is greater in urban than in rural tobacco stores; and are lowest in central Canada, where there is both more in-store advertising for cigarettes and signage prohibiting smoking in stores; and


• alcohol prices are lowest in Quebec.

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“The rapid increase of overweight and obese Canadians and the associated consequences, including hypertension and diabetes, is a major health problem and threatens to halt the declines in cardiovascular disease deaths that Canada has experienced in the past 30 years,” said de Souza.

“Knowledge gaps exist regarding the impact of the built environment – or the human-made physical surroundings – on how someone develops risk factors like high blood pressure, and the variation of these built environments across Canada by region and rurality.”

The researchers were unsurprised to find that the environmental factor trends aligned with health outcomes tracked in other studies.

“Previous Canadian studies have shown that people living in the east have a higher risk of developing heart disease than people living in the west,” said de Souza.

“We also see people who live in rural environments tend to have poorer health than people who live in urban environments.

“This study helps us to understand what we call the ‘causes of the causes’ of diseases like cardiovascular disease. For example, what are the factors that lead to the development of high blood pressure, which can later lead to a stroke or high cholesterol, which later turns into a heart attack?”.

“By understanding how the built environment plays a role, we can intervene both at an individual level, as well as at a community level. It’s one thing for your doctor to tell you that you need to eat more fruits and vegetables to lower your blood pressure, but what if your grocery store prices are so high that you cannot afford them? Or if to get to your grocery store, you have to drive for 30 minutes? If five to 10 servings of fruit and/or vegetables are recommended daily, we should advocate for everyone to be able to afford and access those servings,” commented de Souza.

For full information log on to https://doi.org/10.1080/23748834.2018.1548071