American Heart Association volunteer expert, Joel Kaufman, M.D., MPH, is professor, Environmental & Occupational Health Sciences, Medicine, and Epidemiology and Editor, Environmental Health Perspectives at the University of Washington, Seattle, Washington. Offering perspective on AHA Scientific Sessions 2020 Presentation P224 copyright American Heart Association 2020 "And this is an interesting paper looking at something that we're increasingly interested in, which is a role of features of the environment in predicting the risk of cardiovascular disease. So in this paper, the investigators looked at how much green space there was in an area, and then looked at what the rates of cardiovascular disease is for in the area And found a pretty strong relationship. The problems with a study like this are too full, one of them is that it's what's called a "cross-sectional study", which is just the exposures and the outcomes were measured at one same point in time and so it's hard to say that there's a cause of relationship between them. The other concern is what we call, "ecological study" which is that we don't actually know about the individual people and where they lived in that area, and whether they were actually close to green space. It has to do with just sort of how much green space there was in an area."