Neighborhoods and Cardiovascular Health: A Scientific Statement From the American Heart Association

Abstract

The neighborhoods where individuals reside shape environmental exposures, access to resources, and opportunities. The inequitable distribution of resources and opportunities across neighborhoods perpetuates and exacerbates cardiovascular health inequities. Thus, interventions that address the neighborhood environment could reduce the inequitable burden of cardiovascular disease in disenfranchised populations. The objective of this scientific statement is to provide a roadmap illustrating how current knowledge regarding the effects of neighborhoods on cardiovascular disease can be used to develop and implement effective interventions to improve cardiovascular health at the population, health system, community, and individual levels. PubMed/Medline, CINAHL, Cochrane Library reviews, and ClinicalTrials.gov were used to identify observational studies and interventions examining or targeting neighborhood conditions in relation to cardiovascular health. The scientific statement summarizes how neighborhoods have been incorporated into the actions of health care systems, interventions in community settings, and policies and interventions that involve modifying the neighborhood environment. This scientific statement presents promising findings that can be expanded and implemented more broadly and identifies methodological challenges in designing studies to evaluate important neighborhood-related policies and interventions. Last, this scientific statement offers recommendations for areas that merit further research to promote a deeper understanding of the contributions of neighborhoods to cardiovascular health and health inequities and to stimulate the development of more effective interventions.

Associations Between Neighborhood Racialized Economic Segregation with Cardiometabolic Health and Cortisol in a Racially/Ethnically Diverse Sample of Children from Minneapolis—St. Paul

“… 12 In addition, the American Heart Association recently recommended further study into how structural factors affect CMH, specifically recognizing ICE as a valid classification of residential segregation and place-based inequity. 13 …”

Doença Cardíaca Isquêmica e Nível de Renda – Uma Reflexão Acerca de Determinantes Sociais e Estruturais

“…Em recentes publicações, a American Heart Association tem dirigido sua atenção às desigualdades nos cuidados de saúde, mediadas por determinantes sociais (como renda, educação, segurança, local de moradia e vizinhança) e estruturais (acesso à saúde, saneamento básico, ar limpo, ambiente saudável), e seus impactos deletérios na saúde cardiovascular. 1 - 3 Discute como implementar ações com potencial para eliminar essas desigualdades no cuidado de saúde que afetam desfavoravelmente a saúde cardiovascular 3 das populações marginalizadas. 2 Além disso, aborda estratégias para atingir uma saúde cardiovascular para todos, de forma equânime, com foco no aumento médio da longevidade populacional, 4 haja vista que as doenças cardiovasculares continuam sendo a principal causa de morte mundialmente, inclusive no Brasil, liderada pela doença cardíaca isquêmica.…”

“…In recent publications, the American Heart Association has directed its attention to inequalities in healthcare, mediated by social (such as income, education, safety, place of residence, and neighborhood) and structural determinants (access to healthcare, basic sanitation, clean air, healthy environment), and its deleterious impacts on cardiovascular health. 1 - 3 It discusses how to implement actions with the potential to eliminate these inequalities in health care that adversely affect the cardiovascular health 3 of marginalized populations. 2 In addition, it addresses strategies to achieve cardiovascular health for all in an equitable way, with a focus on increasing the average population longevity, 4 given that cardiovascular diseases continue to be the main cause of death worldwide, including in Brazil, led by ischemic heart disease.…”