Neighborhood Environmental Health and Premature Death From Cardiovascular Disease

Abstract

IntroductionCardiovascular disease (CVD) is the leading cause of death in the United States and disproportionately affects racial/ethnic minority groups. Healthy neighborhood conditions are associated with increased uptake of health behaviors that reduce CVD risk, but minority neighborhoods often have poor food access and poor walkability. This study tested the community-driven hypothesis that poor access to food at the neighborhood level and poor neighborhood walkability are associated with racial disparities in premature deaths from CVD.MethodsWe examined the relationship between neighborhood-level food access and walkability on premature CVD mortality rates at the census tract level for the city of Atlanta using multivariable logistic regression models. We produced maps to illustrate premature CVD mortality, food access, and walkability by census tract for the city.ResultsWe found significant racial differences in premature CVD mortality rates and geographic disparities in food access and walkability among census tracts in Atlanta. Improved food access and walkability were associated with reduced overall premature CVD mortality in unadjusted models, but this association did not persist in models adjusted for census tract population composition and poverty. Census tracts with high concentrations of minority populations had higher levels of poor food access, poor walkability, and premature CVD mortality.ConclusionThis study highlights disparities in premature CVD mortality and neighborhood food access and walkability at the census tract level in the city of Atlanta. Improving food access may have differential effects for subpopulations living in the same area. These results can be used to calibrate neighborhood-level interventions, and they highlight the need to examine race-specific health outcomes.

Community Engagement of African Americans in the Era of COVID-19: Considerations, Challenges, Implications, and Recommendations for Public Health

“…The MSM PRC relies on a deeply rooted, community partnership model that responds to the health priorities of vulnerable African American residents before, during, and after public health emergencies such as the COVID-19 pandemic. For more than 20 years, the MSM PRC has applied dynamic CBPR approaches that focus on prevention, establish partnerships between communities and research entities, and are culturally tailored ( 6 , 55 – 57 ).…”

“…Racial/ethnic minority populations have historically borne a disproportionate burden of illness, hospitalization, and death during public health emergencies, including the 2009 H1N1 influenza pandemic and the Zika virus epidemic (1)(2)(3)(4). This disproportionate burden is due to a higher level of social vulnerability -"individual and community characteristics that affect capacities to anticipate, confront, repair, and recover from the effects of a disaster" -among racial/ethnic minority populations than among non-Hispanic White populations (5). These characteristics include, but are not limited to, low socioeconomic status and power, predisposing racial/ethnic minority populations in general and African Americans in particular to less-than-optimal living conditions.…”

“…These characteristics include, but are not limited to, low socioeconomic status and power, predisposing racial/ethnic minority populations in general and African Americans in particular to less-than-optimal living conditions. Some racial/ethnic minority populations are more likely than non-Hispanic White populations to live in densely populated areas, overcrowded housing, and/or multigenerational homes; lack adequate plumbing and access to clean water; and/or have jobs that do not offer paid leave or the opportunity to work from home ( 6 , 7 ). These factors contribute to a person’s ability to comply with the mitigation mandates of the coronavirus disease 2019 (COVID-19) pandemic established to reduce risk for infection, such as physical distancing and sheltering in place ( 8 ).…”

“…4 Phoebe Putney Memorial Hospital, Albany, Georgia. 5 Satcher Health Leadership Institute, Morehouse School of Medicine, Atlanta, Georgia. 6 Visions, Incorporated, Atlanta, Georgia.…”

Identifying hotspots of cardiometabolic outcomes based on a Bayesian approach: The example of Chile

“…De Groot (2019) show that populations in urban areas had higher levels of low-density lipoprotein (LDL) cholesterol and triglycerides compared to rural areas [15]. In addition, differences in neighbourhoods in terms of food accessibility and walkability may be associated with higher cardiovascular mortality and premature death [16].…”