Skip to main content

Thank you for visiting You are using a browser version with limited support for CSS. To obtain the best experience, we recommend you use a more up to date browser (or turn off compatibility mode in Internet Explorer). In the meantime, to ensure continued support, we are displaying the site without styles and JavaScript.

Neighbourhood built environment and cardiovascular disease: knowledge and future directions

Awareness of the effect of the neighbourhood built environment on cardiovascular diseases is growing. In this Comment, we identify major conceptual, methodological and policy-relevant issues in research related to the built environment and describe potential future directions to improve the scientific rigour of research in this field.

Access options

Rent or Buy article

Get time limited or full article access on ReadCube.


All prices are NET prices.

Fig. 1: Simplified relationships between the neighbourhood built environment and CVD.


  1. 1.

    Chokshi, D. A. & Farley, T. A. Changing behaviors to prevent noncommunicable diseases. Science 345, 1243–1244 (2014).

    CAS  Article  Google Scholar 

  2. 2.

    Nieuwenhuijsen, M. J. Influence of urban and transport planning and the city environment on cardiovascular disease. Nat. Rev. Cardiol. 15, 432–438 (2018).

    Article  Google Scholar 

  3. 3.

    Chandrabose, M. et al. Built environment and cardio-metabolic health: systematic review and meta-analysis of longitudinal studies. Obes. Rev. 20, 41–54 (2019).

    CAS  Article  Google Scholar 

  4. 4.

    Gascon, M. et al. Residential green spaces and mortality: a systematic review. Environ. Int. 86, 60–67 (2016).

    Article  Google Scholar 

  5. 5.

    Kärmeniemi, M. et al. The built environment as a determinant of physical activity: a systematic review of longitudinal studies and natural experiments. Ann. Behav. Med. 52, 239–251 (2018).

    Article  Google Scholar 

  6. 6.

    Rajagopalan, S., Al-Kindi, S. G. & Brook, R. D. Air pollution and cardiovascular disease: JACC state-of-the-art review. J. Am. Coll. Cardiol. 72, 2054–2070 (2018).

    CAS  Article  Google Scholar 

  7. 7.

    Cohen, B. E., Edmondson, D. & Kronish, I. M. State of the art review: depression, stress, anxiety, and cardiovascular disease. Am. J. Hypertens. 28, 1295–1302 (2015).

    CAS  Article  Google Scholar 

  8. 8.

    Kwan, M.-P. The neighborhood effect averaging problem (NEAP): an elusive confounder of the neighborhood effect. Int. J. Environ. Res. Public Health 15, 1841 (2018).

    Article  Google Scholar 

  9. 9.

    Chaix, B. How daily environments and situations shape behaviors and health: momentary studies of mobile sensing and smartphone survey data. Health Place (2019).

    Article  PubMed  Google Scholar 

  10. 10.

    Garg, P. K., Jorgensen, N., Moore, K., Soliman, E. Z. & Heckbert, S. R. Neighborhood environments and risk of incident atrial fibrillation: the Multi-Ethnic Study of Atherosclerosis. Eur. J. Prev. Cardiol. (2019).

    Article  PubMed  Google Scholar 

Download references


G.R.M. is supported by a Canadian Institutes of Health Research Foundations Scheme Grant (FDN-154331). K.O. is supported by the MEXT-Supported Program for the Strategic Research Foundation at Private Universities, 2015–2019, from the Japan Ministry of Education, Culture, Sports, Science and Technology (S1511017).

Author information



Corresponding author

Correspondence to Mohammad Javad Koohsari.

Ethics declarations

Competing interests

The authors declare no competing interests. In particular, none of the authors has a financial interest in Walk Score.

Additional information

Related links

Walk Score:

Rights and permissions

Reprints and Permissions

About this article

Verify currency and authenticity via CrossMark

Cite this article

Koohsari, M.J., McCormack, G.R., Nakaya, T. et al. Neighbourhood built environment and cardiovascular disease: knowledge and future directions. Nat Rev Cardiol 17, 261–263 (2020).

Download citation

Further reading


Quick links

Nature Briefing

Sign up for the Nature Briefing newsletter — what matters in science, free to your inbox daily.

Get the most important science stories of the day, free in your inbox. Sign up for Nature Briefing