Abstract MPTU18: Single Family Zoning and Optimal Cardiovascular Health Measured using the American Heart Association’s Life’s Essential 8 in the Multi-Ethnic Study of Atherosclerosis

E Ebiere Okah (University of Minnesota, Falcon Heights, Minnesota, United States) D David Van Riper (University of Minnesota, Minneapolis, Minnesota, United States) J Jeffrey Misialek (University of Minnesota, Minneapolis, Minnesota, United States) J Jana Hirsch H Hongyan Ning (NORTHWESTERN UNIVERSITY, Chicago, Illinois, United States) M Mahasin Mujahid (UC Berkeley, Berkeley, California, United States) T Tene Lewis (EMORY UNIVERSITY, Atlanta, Georgia, United States) D David Haynes (University of Minnesota, Minneapolis, Minnesota, United States) K Kamakshi Lakshminarayan (UNIVERSITY OF MINNESOTA, Minneapolis, Minnesota, United States) J Jim Pankow (University of Minnesota, Minneapolis, Minnesota, United States) P Pamela Lutsey (University of Minnesota, Minneapolis, Minnesota, United States)

Abstract

Background: Single-family zoning (SFZ) is an urban planning regulation that prevents neighborhoods zoned for single-family homes from developing multifamily housing units, which are often more affordable and disproportionately utilized by lower-income individuals. We evaluated whether SFZ was related to cardiovascular health. Methods: We used 2010-2011 data from the Multi-Ethnic Study of Atherosclerosis (MESA) study and 2010-2012 zoning data of the 6 MESA study sites. SFZ was defined as the percentage of land zoned as single-family within a one-mile radius of the study participants’ homes. Cardiovascular health was defined as the American Heart Association’s Life’s Essential Eight (LE8) composite measure, comprised of diet, physical activity, smoking status, body mass index, cholesterol level, fasting blood glucose, and blood pressure. Higher scores implied better health. We also calculated a measure without sleep (LE8-no sleep) since sleep data were missing on 50% of participants. Multivariable linear mixed models, controlling for sex, education, income, and age, and accounting for clustering by census tract, were used to examine the relationship between SFZ and LE8/LE8-no sleep, overall and by MESA site. Results: Among MESA participants (N=3,550), SFZ was greatest in buffers around those residing in Winston-Salem County, NC (median: 70%) and lowest in Upper Manhattan/Bronx, NY (0%). Overall, living in an area with 10% more SFZ was associated with higher LE8-no sleep scores (β: 0.21, 95% CI: 0.005, 0.42). In stratified analyses, a 10% increase in SFZ was associated with greater LE8-no sleep in Baltimore County (β: 1.14, 95% CI: 0.47, 1.81) and Los Angeles County (β: 0.80, 95% CI: 0.14, 1.45). In Chicago, a 10% increase in SFZ was associated with lower LE8-no sleep (β: -1.42, 95% CI: -2.14, -0.70) and LE8 (β: -1.20, 95% CI: -2.11, -0.29). Conclusion: The relationship between SFZ and cardiovascular health may differ between locations. As cities consider creating or rescinding policies of exclusionary zoning, the implications on health should be considered.

Article Details

Journal Circulation
Volume / Issue Vol. 153, Issue Suppl_1
Published March 24, 2026
ISSN 0009-7322
Publisher Lippincott Williams & Wilkins

Journal Info

Circulation

Lippincott Williams & Wilkins

ISSN: 0009-7322 Health Sciences

Authors (11)

E

Ebiere Okah

University of Minnesota, Falcon Heights, Minnesota, United States

D

David Van Riper

University of Minnesota, Minneapolis, Minnesota, United States

J

Jeffrey Misialek

University of Minnesota, Minneapolis, Minnesota, United States

J

Jana Hirsch

H

Hongyan Ning

NORTHWESTERN UNIVERSITY, Chicago, Illinois, United States

M

Mahasin Mujahid

UC Berkeley, Berkeley, California, United States

T

Tene Lewis

EMORY UNIVERSITY, Atlanta, Georgia, United States

D

David Haynes

University of Minnesota, Minneapolis, Minnesota, United States

K

Kamakshi Lakshminarayan

UNIVERSITY OF MINNESOTA, Minneapolis, Minnesota, United States

J

Jim Pankow

University of Minnesota, Minneapolis, Minnesota, United States

P

Pamela Lutsey

University of Minnesota, Minneapolis, Minnesota, United States