{"doi":"10.1080/28352610.2025.2494564","title":"Urban greenspace and cardiovascular disease comorbidity at breast cancer diagnosis in the US: regional, racial/ethnic, and socioeconomic variations among older women","abstract":"Objective: To investigate the association between urban residential greenspace and cardiovascular disease (CVD) comorbidity at breast cancer (BC) diagnosis among older women, and explore regional, racial/ethnic, and socioeconomic differences. Study design: This is a cross-sectional analysis of a population-based registry data. Methods: Using the Surveillance, Epidemiology, and End Results (SEER)-Medicare linked database, data on women aged 66-90 diagnosed with BC (2010-2017) were analyzed. A tract-level measure of tree canopy cover was derived from the National Landcover Database (2011) and linked to SEER-Medicare records. Logistic regression models assessed the probability of CVD comorbidity based on state-specific percent tree canopy quartiles, adjusting for census tract clustering and covariates. Results: Out of 116,660 women, 74.7% (n=87,152) had CVD comorbidity at BC diagnosis. Overall, women residing in areas with higher percent tree canopy cover had a lower likelihood of CVD comorbidity compared to those in the lowest canopy areas, with an Adjusted Odds Ratio (AOR) and 95% confidence interval (CI) of 0.78 (0.71-0.85). Racial/ethnic, socioeconomic status (SES), and regional variations were noted. Adjusted effects of greenspace were significant only for NHW women; AOR (95%CI) = 0.78 (0.71-0.86). Women in the highest tree canopy quartile in California, New Jersey, and New Mexico had lower odds of comorbid CVD, with AORs (95% CI) of 0.80 (0.72-0.88), 0.77 (0.71-0.84), and 0.46 (0.34-0.63) respectively. Adjusted results for New York, Massachusetts, and Kentucky showed adverse harmful effects, while adjusted results for all other SEER states were not statistically significant. Both dual enrollment eligible and non-eligible women had benefits from greenspace, but greater benefits were observed in dual enrollment eligible women; AOR (95% CI)= 0.64 (0.48-0.86) versus 0.76 (0.69-0.84) for non-eligible women. Conclusions: Overall, urban greenspace is associated with a lower risk of CVD comorbidity among older women with BC, and variations exist by region, race/ethnicity, and SES. Our findings underscore the role of greenspace in mitigating Cardio-Oncology disparities. Further research is needed to better understand factors contributing to observed differences across SEER regions and racial/ethnic subgroups. A better understanding of interactions among greenspace, other environmental factors, and individual lifestyle factors will help improve CVD outcomes among women with BC.","journal":"Cancer Survivorship Research & Care","year":2025,"id":541066,"datarank":0.16479184330021646,"base_score":1.0986122886681096,"endowment":1.0986122886681096,"self_citation_contribution":0.16479184330021646,"citation_network_contribution":0.0,"self_endowment_contribution":0.16479184330021646,"citer_contribution":0.0,"corpus_percentile":29.844511487584125,"corpus_rank":8690,"citation_count":2,"citer_count":1,"citers_with_citation_signal":0,"citers_with_endowment":0,"datacite_reuse_total":0,"is_dataset":true,"is_dataset_confidence":0.5668,"is_data_producer":false,"deposit_databanks":null,"is_oa":true,"file_count":0,"downloads":0,"has_version_chain":false,"published_date":"2025-01-01","fair_score":null,"fair_percentile":null,"algorithm_id":"datarank_citation_only_1hop_v6","ranking_scope":"data_only","authors":[{"id":581478,"name":"Emily L. McGinley","orcid":"0000-0003-3837-2558","position":1,"is_corresponding":false},{"id":581476,"name":"Yuhong Zhou","orcid":"0000-0002-3658-1308","position":2,"is_corresponding":false},{"id":384664,"name":"Sergey Tarima","orcid":"0000-0001-7542-1094","position":3,"is_corresponding":false},{"id":866338,"name":"Jamila Kwarteng","orcid":"0000-0001-7050-4931","position":4,"is_corresponding":false},{"id":271102,"name":"Andreas Beyer","orcid":"0000-0001-9129-7492","position":5,"is_corresponding":false},{"id":581479,"name":"Tina Yen","orcid":"0000-0001-7210-4333","position":6,"is_corresponding":false},{"id":581658,"name":"Aaron N. Winn","orcid":"0000-0003-2906-3913","position":7,"is_corresponding":false},{"id":581475,"name":"Kirsten Beyer","orcid":"0000-0002-7513-8528","position":8,"is_corresponding":false},{"id":866336,"name":"Jean C. Bikomeye","orcid":"0000-0003-0013-1628","position":0,"is_corresponding":true}],"reference_count":52,"raw_metadata":null,"created_at":"2026-07-19T02:52:42.901627Z","pmid":"40881314","pmcid":"PMC12382361","fwci":null,"citation_percentile":null,"influential_citations":0,"oa_status":null,"license":null,"views":0,"total_file_size_bytes":0,"version_count":0,"fair_f":null,"fair_a":null,"fair_i":null,"fair_r":null,"fair_zscore":null,"fair_rationale":null,"fair_model":null,"fair_agent_version":null,"fair_fulltext_source":null,"fair_has_llm":null,"fair_computed_at":null,"clinical_trials":[],"software_tools":[],"db_accessions":[],"linked_datasets":[],"topics":[]}