Neighborhood Walkability, Green Space, and Incident Hip Fracture among Older U.S. Adults: The Cardiovascular Health Study.

Greater neighborhood walkability is linked to a 28% reduction in hip fracture risk among older women in the U.S., with no significant effect observed overall or in men.

• Why it matters: Hip fractures are a major health concern for older adults, and understanding environmental factors that may influence fracture risk can inform prevention strategies. The evidence on neighborhood green space and walkability's impact on fractures remains limited and inconsistent, especially regarding sex differences.
• What they did: A prospective cohort study analyzed 3,676 adults aged 65 and older from the Cardiovascular Health Study, assessing neighborhood walkability and green space around residences from 1992-1993, and tracked incident hip fractures over 12 years using hospital discharge data.
• The result: Higher neighborhood walkability was significantly associated with lower hip fracture incidence among women (hazard ratio 0.72 per standard deviation increase), suggesting walkable environments may help reduce fracture risk in older women, while green space showed no significant association.