Living Close to Water Is Associated with Reduced Risks of Mortality in Canada's Largest Cities: Results from the Canadian Census Health and Environment Cohort

摘要

Increasing evidence suggests that residential exposures to natural environments, such as green space, are associated with many health benefits. Only a single study has examined the potential link between living near water and mortality. Here, we examine whether living near large, natural water features (e.g., lakes, rivers, coasts, "blue space") is associated with decreased risk of dying from cause-specific mortality among urban, Canadian adults, controlling for many individual and contextual covariates, along with exposures to ambient air pollution and residential greenness. Specifically, we examined whether living within 250 m of blue space was associated with cause-specific mortality among adults living in the 30 largest Canadian cities drawn from the 2001 Canadian Census Health and Environment Cohort. Our cohort included ～1.3 million subjects at baseline, 106,180 of whom died from non-accidental causes during the 11 years of follow-up. We found significant, reduced risks of mortality in the range of 12-17% associated with living within 250 m of water compared to living further away, among all causes of death examined, except with external/accidental causes. For example, in fully-adjusted models, the hazard ratio for non-accidental deaths was 0.879; 95% confidence intervals: 0.861-0.897. Effects were more protective among women and older adults, and most protective for deaths from stroke and respiratory-related causes. Our findings suggest that everyday residential exposures associated with living near blue space in urban areas have important benefits to health, which may be different from those achieved through purposeful visits to natural areas, such as parks or beaches. The findings here suggest that exposures to blue spaces in particular may have much stronger benefits to health than previously suggested.