Neighborhood Social Environment and Cardiovascular Disease Risk

Abstract

Purpose of review: Limited physical activity (PA) and obesity are two primary risk factors for cardiovascular disease (CVD). Within a socio-ecological framework, neighborhood social environment may play a key role in influencing PA and obesity. However, the mechanisms underlying this relationship remain ambiguous. Our goals in this review are: (1) to summarize findings from the recent studies on neighborhood social environment in relation to PA and obesity as CVD risk factors, and (2) to briefly describe several innovative approaches to assessing neighborhood social environment. Recent findings: Almost all recent studies assessed neighborhood social environment around residential areas. There were consistent associations between neighborhood social environment and PA and obesity, with some exceptions (indicating null associations or paradoxical associations). However, a focus on residential social environment may limit results because these studies did not account for any exposures occurring away from individuals’ homes. Additionally, the majority of studies utilized a cross-sectional design, which limits our ability to make inferences regarding the causality of the association between social environment and PA or obesity as CV risk factors. Summary: The majority of the studies on neighborhood social environment characterized factors around residential areas and assessed participant activity via self-reported surveys. Future research should leverage tools to account for the spatial mismatch between environmental exposures and outcomes by using global positioning systems, ecological momentary assessments, virtual neighborhood audits, and simulation modeling. These approaches can overcome major limitations by tracking individuals’ daily activity and real-time perceptions of neighborhood social environments linked to CVD events.

Health Disparities in COVID-19: Addressing the Role of Social Determinants of Health in Immune System Dysfunction to Turn the Tide

“…In this perspective we have highlighted inflammation and immune cell changes as potential mediators of the relationships between exposure to adverse social conditions and COVID-19 severity and outcomes. It is known that existing inequities, may lead to the disproportionate burden of chronic diseases, such as asthma ( 116 – 118 ), Type 2 diabetes ( 119 , 120 ), obesity ( 121 – 126 ), and cardiovascular disease ( 127 – 129 ). In turn, these chronic diseases could mediate associations between social factors and worsening COVID-19 severity and outcomes ( 1 , 130 ).…”

Obesity and the Built Environment: A Reappraisal

“…Therefore, careful confounding control is needed as there are several socioeconomic and sociodemographic factors that are associated with both where a person lives and the risk of obesity, which, in turn, may vary based on the shape and scale of the defined area . Interestingly, the incongruence in area‐level socioeconomic advantage or disadvantage between residential BE versus AS BE and its relationship to health is currently an active area of research that, to date, has produced mixed findings .…”

“…In order to overcome issues with the timing of BE exposures relative to the distal outcomes of interest, investigators have increasingly turned to EMA to capture real‐time, proximal dietary and PA decision‐making as well as mood as it occurs in a real‐world setting . EMA is able to capture dynamic behaviors as they occur throughout the day and can allow investigators to observe the array of risk factors that precipitate a change in behavior that is spatiotemporally linked to the GPS‐derived area measures . This method of data collection often uses short message services or applications via mobile devices and therefore it can often be coupled with GPS and accelerometer data.…”

“…This method of data collection often uses short message services or applications via mobile devices and therefore it can often be coupled with GPS and accelerometer data. EMA represents an exciting and rapidly growing field of exposure and outcome assessment that is readily applicable to the study of the BE and health and that complements new and evolving GPS‐derived metrics .…”

Physical activity-mediated associations between perceived neighborhood social environment and depressive symptoms among Jackson Heart Study participants

“…In addition to being related to PNSE [19], PA is a well-demonstrated behavioral risk factor for depression [20][21][22][23]. Studies have found that higher levels of PA are related to lower depression levels [20].…”