Double-jeopardy: The joint impact of neighborhood disadvantage and low social cohesion on cumulative risk of disease among African American men and women in the Jackson Heart Study

Abstract

Objectives Few studies have examined the joint impact of neighborhood disadvantage and low social cohesion on health. Moreover, no study has considered the joint impact of these factors on a cumulative disease risk profile among a large sample of African American adults. Using data from the Jackson Heart Study, we examined the extent to which social cohesion modifies the relationship between neighborhood disadvantage and cumulative biological risk (CBR)—a measure of accumulated risk across multiple physiological systems. Methods Our analysis included 4,408 African American women and men ages 21–85 residing in the Jackson, MS Metropolitan Area. We measured neighborhood disadvantage using a composite score of socioeconomic indicators from the 2000 US Census and social cohesion was assessed using a 5-item validated scale. Standardized z-scores of biomarkers representing cardiovascular, metabolic, inflammatory, and neuroendocrine systems were combined to create a CBR score. We used two-level linear regression models with random intercepts adjusting for socio-demographic and behavioral covariates in the analysis. A three-way interaction term was included to examine whether the relationship between neighborhood disadvantage and CBR differed by levels of social cohesion and gender. Results The interaction between neighborhood disadvantage, social cohesion and gender was statistically significant (p=0.05) such that the association between living in a disadvantaged neighborhood and CBR was strongest for men living in neighborhoods with low levels of social cohesion (B=0.63, SE: 0.32). In gender-specific models, we found a statistically significant interaction between neighborhood disadvantage and social cohesion for men (p=0.05) but not for women (p=0.50). Conclusion Neighborhoods characterized by high levels of economic disadvantage and low levels of social cohesion contribute to higher cumulative risk of disease among African American men. This suggests that they may face a unique set of challenges that put them at greater risk in these settings.

Neighborhood Socioeconomic Deprivation and Allostatic Load: A Scoping Review

“…The literature search yielded 14 eligible papers [ 10 , 16 , 26 , 27 , 28 , 29 , 30 , 31 , 32 , 33 , 34 , 35 , 36 , 37 ], published from 2009 to 2016. Detailed information on their main characteristics can be found in the Supplementary Table 1 ( Table S1 ).…”

“…The mean sample size was 3068 participants, ranging between 420 [ 31 ] and 13,199 [ 26 ]. Twelve out of the 14 studies used adult samples [ 16 , 26 , 27 , 28 , 29 , 30 , 32 , 34 , 35 , 36 , 37 , 38 ] and two focused on youth [ 31 , 33 ]. Seven studies included participants of different races/ethnicities [ 16 , 26 , 27 , 28 , 29 , 30 , 38 ], four studies exclusively focused on Blacks [ 31 , 33 , 35 , 36 ], and one on Hispanics [ 34 ].…”

Changes in perceptions of neighborhood environment and Cardiometabolic outcomes in two predominantly African American neighborhoods

“…In general, the cross-sectional literature shows a consistent relationship between neighborhood disadvantage and obesity/higher BMI levels, and cardiometabolic risk factors [36,37]. For example, data from the Jackson Heart Study showed that neighborhood disadvantage was associated with a 25% increase of CVD and greater cumulative biological risk (using eight biomarkers of cardiovascular, metabolic, inflammatory, and neuroendocrine systems) [38][39][40]. Moreover, higher neighborhood-levels of violence and disorder were associated with 30% higher odds of smoking and lower neighborhood social cohesion was associated with higher odds of smoking and heavy alcohol use [41].…”

Residential and GPS-Defined Activity Space Neighborhood Noise Complaints, Body Mass Index and Blood Pressure Among Low-Income Housing Residents in New York City

“…There is a need to investigate how neighborhood environments influence CVD risk, especially for socially disadvantaged individuals [12, 13]. In particular, neighborhood noise is an important factor that is an understudied neighborhood exposure, which may play a role in population health and health disparities.…”