Associations of street-view greenspace exposure with cardiovascular health (Life’s Essential 8) among women in midlife

Plain English summary Many women experience suboptimal cardiovascular health during midlife, increasing their risk of heart disease. Research suggests that exposure to greenspace, such as vegetation and trees, may benefit heart health, but most studies have relied on satellite images rather than street-level views. In this study, we used Google Street View images and artificial intelligence to measure visible greenspace around the homes of 767 women from the Project Viva study in Eastern Massachusetts. We assessed greenspace exposure from trees, grass, and other plants within 500 m of their homes between 2012 and 2016 and examined its association with cardiovascular health scores about five years later, accounting for individual and neighborhood socioeconomic status. We evaluated cardiovascular health scores using the Life’s Essential 8 (LE8) construct, which includes behavioral factors (diet, physical activity, sleep, and smoking) and biomedical factors (body mass index, blood pressure, blood lipids, and blood glucose). Our results showed that women living in areas with more total greenspace—particularly more trees—had higher overall cardiovascular health scores. Living in an area with higher amounts of visible trees was associated with a healthier diet, better sleep, higher physical activity levels, smoking avoidance, and healthier body weight, blood pressure, and blood sugar levels. These findings suggest that increasing trees in neighborhoods could support better cardiovascular health among women in midlife. Policies promoting urban tree planting may be a valuable public health strategy to improve heart health and overall well-being.