Residential Proximity to Major Roadways and Prevalence of Hypertension in the Atlanta, GA Metropolitan Area translation missing: zh.hyrax.visibility.files_restricted.text

Chang, Alexander (Spring 2018)

Permanent URL: https://etd.library.emory.edu/concern/etds/j098zb10q?locale=zh
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Abstract

Background: Hypertension contributed to the death of 1,100 Americans per day in 2014.  Air and noise pollution, particularly from traffic sources, can affect cardiovascular health.  Increasing urbanization in the United States is resulting in more people living closer to high traffic roadways; the implications of this trend for cardiovascular health are unclear.  The purpose of this study was to estimate associations of residential proximity to major roadways and hypertension and blood pressure outcomes in a metropolitan Atlanta area cohort.     

 

Methods: Residential proximity to major roadways was assessed for a cohort of Emory University employees (n=635) recruited during 2008-2010.  Baseline hypertension status (>130/80 mmHg) and blood pressure readings were acquired for each participant.  Associations of residential roadway proximity (as a categorical or continuous metric) with hypertension status and systolic and diastolic blood pressure were estimated using logistic and linear regression respectively, controlling for potential confounders.  Estimated primary traffic-related fine particle (PM2.5), nitrogen oxides (NOx), and carbon monoxide (CO) concentrations at participant residences and participant anxiety and perceived stress levels from survey data were tested as potential mediators of the association between roadway proximity and the outcomes.   

 

Results: Adjusting for covariates, participants living within 100 m of a major roadway had 2.32 (95% CI: 0.98, 5.50) the odds of having hypertension, and participants living 100 to 500 m from a major roadway had 1.41 (95% CI: 0.85, 2.33) the odds of having hypertension, compared to those living greater than 500 m from a major roadway.  Within the 100 m zone, those living 50 m to 100 m of a major roadway were most at risk, with an odds ratio of 6.14 (95% CI: 1.37, 6.89) compared to the reference level of >500 m.  The patterns of association across roadway proximity categories were similar for blood pressure.  Traffic-related air pollution was found to mediate only some of the observed effects of residential roadway proximity.  Roadway proximity as a continuous linear predictor was not significantly associated with the outcomes.

 

Conclusions: Results suggest that living within 100 m of a major roadway within the Atlanta area may increase the odds of having hypertension.

Table of Contents

I.                  INTRODUCTION…………………………...1

II.               METHODOLOGY…………………..........4

Data Acquisition and Management………...4

CHDWB Cohort Data…….………....5

Heart Medication Data..........………..7

Roadway Data and Roadway Proximity Metrics......…….7

Air Quality Data…………..…………9

Statistical Analysis……….…………………….10

Feature Selection……………….……10

Modeling Framework………………..13

III.            RESULTS…………………………………….14

Descriptive Analysis………………………...14

Demographics………………………..14

Lifestyle Factors……………………..15

Environmental Factors………………16

Residential Roadway Proximity Metrics…………………………17

Analyses of Categorical Roadway Proximity Metrics & Outcomes…......16

Associations of 3-Level Roadway Metric with the Outcomes….....17

Associations of 4-Level Roadway Metric with the Outcomes….....19

Analyses of Continuous Proximity Measures and Outcomes……...….....20

IV.            DISCUSSION………………………………..20

Limitations……………………………23

V.                CONCLUSIONS AND FUTURE RECOMMENDATIONS…………....25

VI.             WORKS CITED………………………….27

VII.          TABLES AND FIGURES………………….43

 

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