{"doi":"10.5853/jos.2022.02922","title":"Precision Greenness and Stroke/Transient Ischemic Attack in 249,405 US Medicare Beneficiaries","abstract":"Stroke is the fifth leading cause of death in the United States and the second leading cause of death globally, which significantly impacts on quality of life and the ability to live independently. 1 There are well-established guidelines for preventing cardiovascular disease and stroke-based on behavioral factors of physical activity, diet, non-smoking, and maintaining a healthy weight; and biomedical parameters of blood pressure, blood glucose, and cholesterol.However, there is an increasing awareness that environmental factors may also be important contextual factors for preventing stroke and its sequelae.An emerging protective factor for chronic disease is neighborhood greenness or vegetative presence, which has been linked to multiple health outcomes including cardiovascular disease 2 and stroke. 3Greenness, including tree canopy and green spaces, may benefit cardiovascular health through multiple mechanisms, including physical activity, social interaction, improved air quality, heat regulation, and restoration from mental fatigue or stress. 4he current study examines whether precision greenness at the micro-environmental level, defined as greenness measured at the census block by the Normalized Difference Vegetation Index (NDVI) from satellite imagery, 5,6 is related to stroke and transient ischemic attack (stroke/TIA). 7We use the term \"precision greenness\" to denote that greenness is measured at the microenvironmental level, the census block.This is a much smaller geographic unit than has been used in prior research. 8Using a relatively small geographic area as a unit of analysis for greenness is novel and has advantages over larger geographic areas.Important among these is that a unit of analysis as small as a census block informs possible mediators of the relationship between greenness and stroke.Another important reason is that it is more cost-effective for governments to target smaller geographic areas when planting because at-risk blocks can be targeted for tree planting.A cross-sectional study in Miami-Dade County, FL, USA, was conducted to examine the relationship of greenness (mean NDVI) at the level of the census block (hereafter, the block) to odds of stroke/TIA among US Medicare beneficiaries aged ≥65 years whose location was unchanged from 2010 to 2011. 9The methods of the study are described elsewhere. 2Data for this retrospective cohort study were obtained from the US Centers for Medicare and Medicaid Services (CMS)' Master Beneficiary Summary File, which provided annual data for each beneficiary on stroke/TIA, age, sex, race/ethnicity, and location for calendar years 2010 and 2011 (Supplementary Figure 1). 7","journal":"Journal of Stroke","year":2023,"id":361544,"datarank":0.0,"base_score":0.0,"endowment":0.0,"self_citation_contribution":0.0,"citation_network_contribution":0.0,"self_endowment_contribution":0.0,"citer_contribution":0.0,"corpus_percentile":null,"corpus_rank":null,"citation_count":8,"citer_count":0,"citers_with_citation_signal":0,"citers_with_endowment":0,"datacite_reuse_total":0,"is_dataset":false,"is_dataset_confidence":0.96,"is_data_producer":false,"deposit_databanks":null,"is_oa":true,"file_count":0,"downloads":0,"has_version_chain":false,"published_date":"2023-01-01","fair_score":null,"fair_percentile":null,"algorithm_id":"datarank_citation_only_1hop_v6","ranking_scope":"data_only","authors":[{"id":1114310,"name":"William Aitken","orcid":"0000-0002-9377-881X","position":1,"is_corresponding":false},{"id":1114311,"name":"Joanna Lombard","orcid":"0000-0002-4925-9633","position":2,"is_corresponding":false},{"id":1114312,"name":"Kefeng Wang","orcid":"0000-0002-8005-269X","position":3,"is_corresponding":false},{"id":310714,"name":"Tatjana Rundek","orcid":"0000-0002-7115-9815","position":4,"is_corresponding":false},{"id":439455,"name":"Margaret M. Byrne","orcid":"0000-0002-8143-4702","position":5,"is_corresponding":false},{"id":1114820,"name":"Matthew Toro","orcid":null,"position":6,"is_corresponding":false},{"id":1114821,"name":"Maria I. Nardi","orcid":null,"position":7,"is_corresponding":false},{"id":1114822,"name":"Jack Kardys","orcid":null,"position":8,"is_corresponding":false},{"id":1114823,"name":"Abraham Parrish","orcid":null,"position":9,"is_corresponding":false},{"id":315653,"name":"José Szapocznik","orcid":"0000-0002-3832-1753","position":10,"is_corresponding":false},{"id":1114309,"name":"Scott C. Brown","orcid":"0000-0002-2541-5750","position":0,"is_corresponding":true}],"reference_count":8,"raw_metadata":null,"created_at":"2026-07-19T01:14:15.063476Z","pmid":"36592966","pmcid":null,"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":[]}