How Living in a Walkable Neighborhood Could Protect Your Heart

Most people know that quitting smoking, exercising, eating well can help keep your heart healthy as you age. But new research suggests that the type of neighborhood you live in could play a role, too.

According to a study presented at the European Society of Cardiology earlier this month, where you live can influence how sedentary you are, and subsequently, your heart health.

The researchers found that people who live in walkable neighborhoods have a lower risk of cardiovascular disease (CVD) as compared to people who have to frequently drive to get to work, school, or the grocery store, for example.

“The findings suggest that neighborhood design plays an important role in cardiovascular health,” Jun Wu, PhD, professor of environmental and occupational health at the University California, Irvine, Joe C. Wen School of Population & Public Health, told Health.

The study also builds on what experts have known for a long time—the more you move, the lower your risk of developing chronic disease.

And increasingly, evidence shows that you don’t need to sign up for a marathon or regularly lift weights to reap the benefits. Rather, short bursts of energy—playing with your dog in a park or carrying your groceries home, for example—can lower your risk of getting heart disease.

To understand how a city’s walkability can influence heart health, the researchers collected data from over 3 million Dutch people who were at least 40 years old and had no history of CVD.

Researchers calculated how walkable each participant’s address was based on the following factors:

• Population density
• Amount of stores nearby
• Access to green space
• Number of sidewalks
• Mixed land use
• Public transit access
• Street connectivity

Residences were given walkability scores over the course of 13 years, and researchers tracked whether neighborhood walkability remained stable, or if it got better or worse over time.

Then, the researchers looked at how many study participants developed CVD over an average of 11 years. The data showed that those who lived in low walkability areas had a 5% higher risk of CVD as compared to those who lived in very walkable neighborhoods.

CVD risk was also about 5% higher in people whose neighborhoods started off with a low walkability score that improved as the years went on. Researchers suspect this could be because these participants’ sedentary behaviors from earlier in life may have lingered—even after their town became more walkable.

“These data reinforce the importance of developing healthy habits like routine exercise early on in life, and continuing to exercise throughout the course of the adult lifespan in order to reduce your risk of developing cardiovascular disease,” William Cornwall, MD, associate professor of cardiology at the University of Colorado Anschutz Medical Campus, told Health.

Being physically active—whether that’s from walking, working out, gardening, or even doing household chores—offers significant heart-healthy benefits.

There’s a large body of evidence showing that exercise helps prevent cardiovascular risk factors like high blood pressure and high cholesterol from developing in the first place, said Michael McConnell, MD, clinical professor of cardiovascular medicine at Stanford Medicine.

It also “improves risk factors if you already have them and reduces the likelihood of having a heart attack, stroke, and atrial fibrillation,” he told Health.

So the results of the study aren’t necessarily surprising—living in a walkable town reduces your reliance on cars and, more or less, forces you to get out and move.

“Walkable areas encourage regular walking for daily activities, which strengthens the heart, improves circulation, lowers blood pressure, regulates cholesterol and blood sugar, and helps maintain a healthy weight,” Yu Chen, PhD, MPH, chronic disease epidemiologist and professor of population health at NYU Langone Health, told Health.

Furthermore, walkable neighborhoods can lower air pollution and noise levels, both of which are associated with reduced cardiovascular health risks, added Wu.

On the flip side, research suggests sedentary lifestyles—which may be more common among people who live in less walkable neighborhoods—can lead to high cholesterol and high blood pressure, raising the risk of stroke or heart attack.

Inactivity can have consequences beyond heart health, too. These can include weight gain, a loss in muscle strength and endurance, weaker bones, and issues with metabolism. Not exercising has also been linked to a higher risk of diabetes and certain cancers, as well as depression symptoms, evidence suggests.

Urban areas are always more walkable than suburban or rural locales. But despite the popularity of America’s cities, a 2023 report from advocacy nonprofit Smart Growth America found that less than 7% of Americans live in walkable urban neighborhoods.

And there are significant disparities in who actually reaps the heart-health benefits of living in a more walkable community.

Research has found that minoritized groups tend to live in more walkable neighborhoods. But, at the same time, people of color are disproportionately affected by cardiometabolic diseases such as CVD.

Why might this be? In the U.S., McConnell explained, people are more likely to walk outside when they feel safe doing so, when their outdoor environment is clean, and when they have access to well-maintained and abundant sidewalks and parks. This may not be the case in underfunded or racially segregated neighborhoods.

You may not have much control over how walkable your neighborhood is (apart from moving somewhere else).

Still, there are things people can do to mimic the activity or movement levels of those who do live in highly-walkable neighborhoods. You might just need to get creative with how you squeeze movement into your week.

You can lift weights or do yoga while watching TV. You can park further away from the grocery store, or take the stairs at work instead of the elevator. Stand whenever you talk on the phone, take walking meetings, or make a point to get up and stretch every hour.

Though it may seem counterintuitive, the key to becoming more active is to start slowly. It’s better, per the National Institutes of Health, to begin with a small burst of activity and gradually ramp up the duration and intensity of your activity. “Every minute of physical activity has health benefits,” McConnell said.

There are plenty of other heart-healthy behaviors you can adopt, too, such as eating a healthy diet, quitting smoking, and getting sufficient sleep each night, added Cornwall.

And if you wish your neighborhood was more walkable, you’re probably not alone. Interest in walkable communities appears to be picking up steam—TikTok videos on the subject have garnered millions of views, and resource tools like 15-Minute City and WalkScore are educating people about living in walkable cities.

Though it’s not possible for every neighborhood to be completely walkable, try to organize with your community to make improvements where you can, Wu said.

Consider advocating to your local government for improvements to sidewalks, parks, bike lanes, parks, and street lighting, she suggested. Launching community projects, like pocket gardens or walking groups, can also boost walkability while strengthening neighborhood ties.

“Cities can become more walkable,” said Wu, “but it requires sustained political will, comprehensive planning, and community engagement.”