PubMed17 Apr 2026Circulation. Population health and outcomes● 4/10i Leveraging Neighborhood-Level Interventions to Improve Cardiovascular Health: A Scoping Review.
Choudhury SH, Holmes DM, Ekwunife OI, Campbell JA, Walker RJ et al.
Neighborhood-level interventions improved cardiovascular health behaviors in 55% of studies, with dietary outcomes showing greatest benefit at 73% and physical activity at 63%. Scoping review of 20 studies including 15 RCTs and 5 quasi-experimental studies targeting built environments, food access, and housing mobility. This provides the first systematic evidence that environmental modifications combined with community support can address social determinants of cardiovascular disease at population scale. However, interventions showed limited impact on clinical cardiometabolic risk factors, suggesting behavioral changes may not translate to measurable health outcomes.
Strategic Signal
This evidence strengthens the case for pharmaceutical companies to integrate social determinants of health into their cardiovascular and metabolic disease strategies. CMS and European HTA bodies increasingly evaluate real-world effectiveness and health equity in coverage decisions, making population health interventions a competitive differentiator. Companies like Novo Nordisk and Eli Lilly could leverage these findings to support value-based contracts that combine GLP-1 therapies with community interventions, potentially improving adherence and outcomes while addressing payer concerns about access disparities.
CardiovascularReal-world evidence
Original Abstract
Cardiovascular disease remains the leading cause of death globally. Neighborhood characteristics such as food environments, green space access, and housing conditions shape cardiovascular health by influencing environmental exposures, resource access, and chronic stress, with disproportionate impacts on socially vulnerable populations. This scoping review aims to identify and evaluate neighborhood-level interventions designed to promote cardiovascular health and determine which strategies are most effective in improving health outcomes. A comprehensive and reproducible search was conducted across PubMed, ScienceDirect, Web of Science, and OVID Medline for studies published between 2015 and 2025. Keywords related to neighborhood-level interventions and cardiovascular health were used to identify relevant articles. Neighborhood-level interventions were defined as strategies that modify the physical, social, or economic environment of geographically defined areas. Outcomes included cardiovascular health behaviors, cardiometabolic risk factors, and clinical cardiovascular outcomes. Twenty studies were included, including 15 randomized controlled trials and 5 quasi-experimental studies. Interventions targeted built environments, food retail environments, housing mobility, or employed multicomponent approaches that coupled environmental intervention with individual or community-level support. Overall, 55% of studies demonstrated beneficial cardiovascular outcomes, 20% showed mixed effects, and 25% showed null effects. Dietary behavior outcomes showed the greatest benefit (73%), followed by physical activity (63%), while cardiometabolic risk factors showed limited improvement. Interventions were particularly effective when they integrated environmental changes with support across multiple levels, including education, peer support, and community resources. Multicomponent interventions coupling neighborhood environmental modifications with either individual or community-level support show promise for improving cardiovascular health behaviors, particularly physical activity and diet in disadvantaged populations. Future work should prioritize long-term studies on interventions that integrate these elements to understand sustainability and measure cost-effectiveness to facilitate implementation of strategies and policy changes that sustain long-term health improvements.