Neighborhood characteristics and ideal cardiovascular health among Black adults: results from the Morehouse-Emory Cardiovascular (MECA) Center for Health Equity

• Type of Material: Article
• Authors: Shabatun J Islam, Emory University; Jeong Hwan Kim, Emory University; Peter Baltrus, Morehouse School of Medicine; Matthew Topel, Emory University; Chang Liu, Emory University; Yi-An Ko, Emory University; Mahasin S Mujahid, University of California Berkeley; Viola Vaccarino, Emory University; Mario Sims, University of Mississippi; Mohamed Mubasher, Morehouse School of Medicine; Ahsan Khan, Emory University; Kiran Ejaz, Emory University; Charles Searles, Emory University; Sandra Dunbar, Emory University; Priscilla Pemu, Morehouse School of Medicine; Herman Taylor, Emory University; Arshed Quyyumi, Emory University; Tene Lewis, Emory University
• Language: English
• Date: 2022-01-01
• Publisher: ELSEVIER SCIENCE INC
• Publication Version: Author Accepted Manuscript (After Peer Review)
• Copyright Statement: © 2020 Elsevier Inc. All rights reserved.
• License: Creative Commons Attribution-NonCommercial-NoDerivs 4.0 International
• Final Published Version (URL): http://dx.doi.org/10.1016/j.annepidem.2020.11.009
• Title of Journal or Parent Work: ANNALS OF EPIDEMIOLOGY
• Volume: 65
• Start Page: 120
• End Page: +
• Grant/Funding Information: The American Heart Association 0000031288, Abraham J. & Phyllis Katz Foundation, Byron Williams Jr, MD Fellowship Fund and the National Institutes of Health T32 HL130025 & T32 HL007745-26A1
• Keywords: IMPACT; UNITED-STATES; Black adults; African Americans; Neighborhood; Science & Technology; ENVIRONMENTS; Life Sciences & Biomedicine; HEART-DISEASE; Cardiovascular health; Public, Environmental & Occupational Health; AFRICAN-AMERICANS; TYPE-2 DIABETES-MELLITUS; RISK; SOCIAL COHESION; MORTALITY; Cardiovascular disease risk factors; DISADVANTAGE; Disparities

Abstract

Purpose: Neighborhood environment is increasingly recognized as an important determinant of cardiovascular health (CVH) among Black adults. Most research to date has focused on negative aspects of the neighborhood environment, with little attention being paid to the specific positive features, in particular the social environment, that promote cardiovascular resilience among Black adults.We examined whether better neighborhood physical and social characteristics are associated with ideal CVH among Black adults, as measured by Life's Simple 7 (LS7) scores. Methods: We recruited 392 Black adults (age 53 ± 10 years, 39% men) without known CV disease living in Atlanta, GA. Seven neighborhood domains were assessed via questionnaire: asthetic quality, walking environment, safety, food access, social cohesion, activity with neighbors, and violence. CVH was determined by LS7 scores calculated from measured blood pressure; glucose; cholesterol; body mass index (BMI); and self-reported exercise, diet, and smoking, and categorized into poor (0–8), intermediate (9–10), and ideal (11–14). Multinomial logistic regression was used to examine the association between neighborhood characteristics and the odds of intermediate/ideal CVH categories compared with poor CVH after adjustment for age, gender, household income, education, marital status, and employment status. Results: Better scores in the neighborhood domains of social cohesion and activity with neighbors were significantly associated with higher adjusted odds of ideal LS7 scores (OR 2.02, 95% CI [1.36–3.01] and 1.71 [1.20–2.45] per 1 standard deviation [SD] increase in respective scores). These associations were stronger for both social cohesion (OR 2.61, 95% CI [1.48–4.61] vs. 1.40 [0.82–2.40]) and activity with neighbors (OR 1.82, 95% CI [1.15–2.86] vs. 1.53 [0.84–2.78]) in Black women than men. Specifically, better scores in social cohesion were associated with higher odds of ideal CVH in exercise (OR 1.73 [1.16–2.59]), diet (OR 1.90 [1.11–3.26]), and BMI (OR 1.52 [1.09–2.09]); better scores in activity with neighbors were also similarly associated with higher odds of ideal CVH in exercise (OR 1.48 [1.00–2.19]), diet (OR 2.15 [1.23–3.77]), and BMI (OR 1.45 [1.07–1.98]; per 1 SD in respective scores). Conclusions: More desirable neighborhood characteristics, particularly social cohesion and activity with neighbors, were associated with better CVH among Black adults.