Association of Neighborhood Characteristics With Cardiovascular Health in the Multi-Ethnic Study of Atherosclerosis

Abstract

Background The concept of ‘cardiovascular health’ (CVH) was introduced as a global measure of one’s cardiovascular health. Previous studies established the relationship between neighborhood characteristics and individual cardiovascular risk factors. However, the relationship between neighborhood environment and overall CVH remains unknown. Methods and Results We analyzed data from the MESA baseline exam (2000–2002). Mean age was 61.6 years and 52% were female. Ideal, intermediate and poor categories of cholesterol, body mass index, diet, physical activity, fasting glucose, blood pressure and smoking were defined according to the AHA 2020 Strategic Goals, assigned an individual score and summed to create an overall score. CVH scores were categorized into ideal (11–14 points), intermediate (9–10) and poor (0–8). Neighborhood exposures included favorable food store and physical activity resources densities (by 1-mile buffer), reported healthy food availability, walking/physical activity environment, safety and social cohesion (by census tract). Multinomial logistic regression was used to determine the association of each characteristic with ideal and intermediate CVH, adjusted for demographics and neighborhood socioeconomic status (SES). Over 20% of MESA participants had an ideal CVH score at baseline. In fully adjusted models, favorable food stores (OR= 1.22, 1.06–1.40), physical activity resources (OR=1.19, 1.08–1.31), walking/physical activity environment (OR=1.20, 1.05–1.37) and neighborhood SES (OR=1.22, 1.11–1.33) were associated with higher odds of having an ideal CVH score. Conclusions Neighborhood environment including favorable food stores, physical activity resources, walking/physical activity environment and neighborhood SES are associated with ideal CVH. Further research is needed to investigate the longitudinal associations between neighborhood environment and CVH.

Trends in Racial/Ethnic Disparities in Cardiovascular Health Among US Adults From 1999–2012

“…Historical policies of social exclusion as well as documented discrimination in access to health‐enhancing resources experienced by racial/ethnic minority groups in the United States are likely contributors to racial/ethnic differences in CVH 16, 17, 18. For example, neighborhoods with a higher percentage of racial/ethnic minority residents—regardless of income—have fewer grocery stores,19 fewer recreation facilities,20 and less walkability21; these neighborhood resources have been linked to preservation of ideal CVH 22. Previous research has shown that individuals who have multiple forms of social disadvantage—such as low income, low education, and nonwhite race—are even less likely to have ideal CVH 11.…”

Life's Simple 7 and Incident Heart Failure: The Multi‐Ethnic Study of Atherosclerosis

“…We categorized the LS7 metrics into ideal, intermediate, and poor with modifications as previously reported in MESA (Table S1). 7, 28 We created the LS7 score from points assigned to each category of the metrics; poor=0 point, intermediate=1 point, and ideal=2 points. The points were summed for a total LS7 score ranging from 0 to 14 29.…”

“…The points were summed for a total LS7 score ranging from 0 to 14 29. As previously described, we considered 0 to 8, 9 to 10, and 11 to 14 points as inadequate, average, and optimal scores, respectively 28. The HF incidence rate per 1000 person‐years was calculated for each ideal metric and LS7 score category stratified by race/ethnicity.…”

Association Between Life's Simple 7 and Noncardiovascular Disease: The Multi‐Ethnic Study of Atherosclerosis

“…Study participants who scored 0 to 8 points were classified as inadequate, those who scored 9 or 10 points were classified as average, and participants who scored 11 to 14 points were classified as optimal 21. Table S1 presents the proportion of MESA participants who fall into each category of the metrics.…”