Abstract MP76: Street View Greenspace Exposures and Cardiovascular Health Among Children - Evidence From Project Viva
Authors: Yi Li , Rifas-Shiman Sheryl L , Aris Izzuddin , Pescador Jimenez Marcia , Lin Pi-I Debby , Suel Esra , Hystad Perry , Larkin Andrew , Hankey Steve , Zhang Wenwen , Oken Emily , Hivert Marie-France , James Peter 
Published: May 2024

Introduction:
Research on greenspace and cardiovascular health (CVH) in children is limited, and most previous studies rely on coarse satellite-based measurements of greenspace, which do not capture exposure as individuals experience it. Street View imagery (SVI) enables measurement of greenspace from a ground-level perspective and captures specific elements of greenspace that may be most relevant to health. This study aimed to examine associations of SVI-based greenspace with CVH in children in Project Viva, an eastern Massachusetts-based cohort.

Methods:
Using data from 1,163 children, we applied deep learning segmentation algorithms to SVI from 2007-2010 to derive metrics of greenspace (%of trees, or grass) within a 500m radius of participants’ residential addresses obtained during mid-childhood (mean age 7.9y). At mid-childhood and early adolescence (mean age 13.2y), we calculated CVH scores (range 0-100 units; higher scores represent better CVH) using the American Heart Association’s Life’s Essential 8 algorithm, based on 4 biomedical measures (body mass index, blood lipids, blood glucose, and blood pressure) and 4 behavioral measures (heart healthy levels of diet, physical activity, avoidance of nicotine, and sleep). Using linear regression, we examined associations of mid-childhood SVI-based greenspace metrics with mid-childhood (cross-sectional) and early adolescence (longitudinal) CVH scores, adjusting for child’s sex, race and ethnicity, and age at outcome, as well as an index score of socioeconomic status comprising individual and neighborhood metrics.

Results:
Among the 1163 participants, 65% were non-Hispanic White and 49% were female. The mean (SD) LE8 score was 83.3 (8.0) in mid-childhood and 81.7 (8.9) in early adolescence. In the unadjusted models, a higher %trees and grass per SD, as measured by SVI within children’s residence in mid-childhood, was associated with a higher overall CVH score (β 1.63 [95%CI: 0.93, 2.33] for trees; β 1.10 [95%CI: 0.36, 1.83] for grass). In longitudinal analyses, the results were similar (β 1.69 [95%CI: 0.87, 2.52] for trees; β 0.82 [95%CI: -0.01, 1.64] for grass). In fully-adjusted analyses, the cross-sectional and longitudinal results for %trees and grass were attenuated and not statistically significant. However, when CVH scores were disaggregated by behavioral and biomedical sub-scores, %trees was positively associated with behavioral sub-scores in cross-sectional fully-adjusted analyses at mid-childhood (β 0.89 [95%CI: 0.32, 1.46]).

Conclusion:
Among participants in Project Viva, SVI-based metrics of greenspace exposure in mid-childhood were cross-sectionally associated with behavioral factors promoting higher CVH. Greenspace may hold promise for improving children’s CVH through the behavioral pathway and should be considered in future health-promotion efforts.