Mobility-Informed Environmental Exposure and Cardiovascular Outcomes Across the Life Course

Environmental determinants of cardiovascular disease extend beyond static residential exposures, yet most studies rely on static, residence-based proxies such as greenness indices that fail to capture lived mobility. We integrated large-scale anonymized mobility with national mortality data and longitudinal outcomes in nearly 3 million individuals from a regional (University Hospitals) and a national (Veterans Affairs) health system cohort (median follow-up: 7.8 and 8.8 years). Mobility-derived exposures included time in green and recreational spaces, and indices of food environments and movement diversity. Greater engagement with green and recreational environments and higher mobility diversity were consistently associated with lower major adverse cardiovascular event risk, with age-dependent attenuation. Healthier food environments demonstrated stronger protective associations in older adults. Ecological validation demonstrated inverse spatial correlations between beneficial mobility exposures and cardiovascular and all-cause mortality rates. Dynamic mobility metrics provide a scalable framework linking lived environmental experience to cardiovascular risk across populations and geographic scales.