Date of Conferral

8-1-2024

Date of Award

August 2024

Degree

Ph.D.

School

Public Health

Advisor

Harrison Ndetan

Abstract

Cardiovascular diseases (CVDs) are a significant public health burden in Mexico despite national efforts to address traditional risk factors. With growing evidence that elements of nature can improve physical and mental health of people living in cities, this quantitative epidemiological study of secondary data examined the relationship between the presence of street trees in Mexican metropolitan areas and self-reported CVD in adults over age 40. The integrated socio-environmental model of health and well-being provided the conceptual framework for the study. A secondary data analysis was performed using combined individual health data from Mexico’s 2012 National Health and Nutrition Survey and environmental data from other governmental sources. Each analysis adjusted for different subsets of known individual and environmental risk factors. Results based on data from 10,798 adults living in urban neighborhoods of Mexico showed a marked trend of reduced likelihood of CVD prevalence as the number of streets with street trees increased, although this finding was not statistically significant after controlling for individual- and household-level factors (adjusted odds ratio [AOR] = 0.84, 95% confidence interval [CI] = [0.56, 1.28], p = .43), after controlling for neighborhood- and municipality-level factors (AOR [95% CI] = 0.95 [0.59, 1.54], p = .83), and after controlling for individual- and household-level factors and adjusting for neighborhood- and municipality-level factors (AOR [95% CI] = 0.87 [0.55, 1.38], p = 0.56). Findings may be relevant to public health practitioners, urban planners, and political leaders who could employ street tree planting to promote health equity and reduce CVD prevalence in cities, thereby contributing to meaningful social change for Mexico’s urbanizing population.

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