Wireless Movement Activity and Cardiometabolic Disease Risk in Historical Redlined Areas.

JACC. Advances · 2026 · Benefit · Low evidence

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BenefitLow evidencePaper 2408

Study snapshot

PublicationJACC. Advances · 2026

Study typeecological

Reported directionBenefit

Evidence ratingLow

Abstract

BACKGROUND: Composite mobility patterns may better model built environment exposures, yet are rarely implemented to understand the prevalence of cardiometabolic disease (CMD). OBJECTIVES: The purpose of this study was to investigate the association between a novel Wireless Movement Index (WMI) and prevalent CMD redlined U.S. census tracts. METHODS: The Homeowners Loan Corporation (HOLC) was used to identify census tracts graded A-D and their age-adjusted prevalence (2019) for systolic hypertension, coronary heart disease, diabetes, obesity, chronic kidney disease, and stroke were collected. From nationally representative cell-phone tracking data, the WMI was constructed to identify population-level movement patterns and visits to points of interest. The association between WMI and disease prevalence was investigated using multivariable linear regression models across HOLC grades. RESULTS: Among 16,352 tracts, 4,458 were classified as HOLC grades A-B, 7,572 as grade C, and 4,322 as grade D. Grade D tract residents reported 55% of their visits to other grade D census tracts, with only 9% to grade A/B census tracts. The WMI was negatively associated with CMD prevalence across all HOLC grades, but this protective association was most pronounced in redlined areas. In grade D tracts, each unit increase in WMI was associated with a -2.33 (95% CI: -2.79 to -1.86), -2.93 (95% CI: -3.42 to -2.45), and -0.99 (95% CI: -1.30 to -0.68) decrease in prevalent hypertension, obesity, and diabetes. CONCLUSIONS: Even among redlined census tracts, those that reported a higher WMI (indicative of more frequent and diverse mobility) were likely to have better population-level cardiometabolic health. WMI may serve as a scalable, dynamic proxy for environmental opportunity and structural inequity.

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AI evidence extraction

Structured fields below were generated from the paper’s abstract and metadata to make the evidence easier to inspect. Automated extraction may be incomplete or incorrect; verify important details against the original paper.

Study typeecological

Effect directionbenefit

PopulationU.S. census tracts (HOLC-graded A–D), 2019 age-adjusted disease prevalence

Sample size16352

ExposureNot supplied

Evidence strengthLowConfidence: 74% · Peer reviewed: yes

Main findings

Using nationally representative cell-phone tracking data, a Wireless Movement Index (WMI) was constructed and was negatively associated with cardiometabolic disease prevalence across all HOLC grades, with the strongest (most protective) associations in redlined (grade D) tracts. In grade D tracts, each unit increase in WMI was associated with decreases in prevalent hypertension (-2.33; 95% CI: -2.79 to -1.86), obesity (-2.93; 95% CI: -3.42 to -2.45), and diabetes (-0.99; 95% CI: -1.30 to -0.68).

Outcomes measured

systolic hypertension (prevalence)
coronary heart disease (prevalence)
diabetes (prevalence)
obesity (prevalence)
chronic kidney disease (prevalence)
stroke (prevalence)

View raw extracted JSON

{
  "study_type": "ecological",
  "exposure": {
    "band": null,
    "source": "mobile phone",
    "frequency_mhz": null,
    "sar_wkg": null,
    "duration": null
  },
  "population": "U.S. census tracts (HOLC-graded A–D), 2019 age-adjusted disease prevalence",
  "sample_size": 16352,
  "outcomes": [
    "systolic hypertension (prevalence)",
    "coronary heart disease (prevalence)",
    "diabetes (prevalence)",
    "obesity (prevalence)",
    "chronic kidney disease (prevalence)",
    "stroke (prevalence)"
  ],
  "main_findings": "Using nationally representative cell-phone tracking data, a Wireless Movement Index (WMI) was constructed and was negatively associated with cardiometabolic disease prevalence across all HOLC grades, with the strongest (most protective) associations in redlined (grade D) tracts. In grade D tracts, each unit increase in WMI was associated with decreases in prevalent hypertension (-2.33; 95% CI: -2.79 to -1.86), obesity (-2.93; 95% CI: -3.42 to -2.45), and diabetes (-0.99; 95% CI: -1.30 to -0.68).",
  "effect_direction": "benefit",
  "limitations": [],
  "evidence_strength": "low",
  "confidence": 0.74,
  "peer_reviewed_likely": "yes",
  "keywords": [
    "Wireless Movement Index",
    "WMI",
    "mobility",
    "cell-phone tracking data",
    "redlining",
    "HOLC",
    "census tracts",
    "cardiometabolic disease",
    "hypertension",
    "obesity",
    "diabetes",
    "structural inequity"
  ],
  "suggested_hubs": []
}

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AI-extracted fields are generated from the abstract and metadata and may be incomplete or incorrect. This material is for informational purposes and is not medical advice.

Identifiers and source

DOI: 10.1016/j.jacadv.2025.102528
PubMed: 41576599

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