A Multi-Scale Geographically Weighted Regression Approach to Understanding Community-Built Environment Determinants of Cardiovascular Disease: Evidence from Nanning, China

Clarifying how the community-scale built environment shapes the spatial heterogeneity of cardiovascular disease (CVD) prevalence is essential for precision urban health interventions. We integrated CVD prevalence data from the Guangxi Zhuang Autonomous Region Hospital (2020–2022) with 14 built-environment indicators across 77 communities in Xixiangtang District, Nanning, and compared ordinary least squares (OLS), geographically weighted regression (GWR), and multiscale geographically weighted regression (MGWR). MGWR provided the best model fit (adjusted R2 increased by 0.136 and 0.056, respectively; lowest AICc and residual sum of squares) and revealed significant scale-dependent effects. Distance to metro stations, road network density, and the number of transport facilities exhibited pronounced local-scale heterogeneity, while population density, building density, healthy/unhealthy food outlets, facility POI density, and public transport accessibility predominantly exerted global-scale effects. High-risk clusters of CVD were identified in mixed-use, high-density urban communities lacking rapid transit access. The findings highlight the need for place-specific, multi-scale planning measures, such as transit-oriented development and balanced food environments, to reduce the CVD burden and advance precision healthy-city development.