ORIGINAL RESEARCH article
Front. Public Health
Sec. Aging and Public Health
Rethinking 15-minute walkable neighborhoods for healthy aging: Evidence from cardiovascular health in Shanghai's older adults
Provisionally accepted
- 1Shanghai Baoshan Center of Disease Prevention and Control, Baoshan, China
- 2Fujian Agriculture and Forestry University, Fuzhou, China
- 3School of Architecture and Urban Planning, Tongji University, Shanghai, China
- 4Fuzhou University, Fuzhou, China
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Interventions targeting chronic diseases through urban built environments have gained increasing attention due to their potential population-level health benefits. However, empirical evidence on the relationship between built environment features and cardiovascular health among older adults remains limited, particularly in ultradense Asian cities experiencing rapid population aging. This study analyzed fine-scale built environment data to delineate 15-minute walkable neighborhoods around 2,579 stroke emergency visits among adults aged 60 to 80 in Shanghai. Participants were classified as survivors or non-survivors based on outcomes during their initial hospitalization, serving as a proxy for cardiovascular health status. Using binary logistic regression, we examined associations between neighborhood environmental characteristics and cardiovascular outcomes. Results indicated that higher residential building density and proximity to major roads were significantly linked to poorer cardiovascular health, whereas greater neighborhood greenness, measured by the Normalized Difference Vegetation Index (NDVI), was associated with better outcomes, especially within socioeconomically disadvantaged neighborhoods. Streetscape features such as visible sky and greenery were positively correlated with better cardiovascular health in more affluent areas. Additionally, a U-shaped relationship emerged between the proportion of residential land use and cardiovascular outcomes in disadvantaged communities. These findings provide nuanced, context-specific insights into how fine-scale built environment factors relate to cardiovascular health among aging urban populations, offering valuable implications for land use planning and healthy urban design.
Keywords: Cardiovascular health, 15-minute walkable neighborhood, cross-sectionalstudy, older adults, Health Disparity
Received: 17 Aug 2025; Accepted: 07 Nov 2025.
Copyright: © 2025 Wu, Liu, Xu, Meng and Wu. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence:
Yanting Xu, 2110297@tongji.edu.cn
Yang Meng, mengyang@bscdc.org.cn
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