The Association between Neighborhood Disorder and Health: Exploring the Moderating Role of Genotype and Marriage

Abstract

The present study extends prior research on the link between neighborhood disorder and health by testing an integrated model that combines various social and biological factors. Hypotheses were tested using a sample of 325 African American women from the Family and Community Health Study (FACHS). As expected, inflammatory burden was the biophysiological mechanism that mediated much of the association between neighborhood physical disorder and perceived physical health. This finding provided additional support for the view that global self-ratings of health are powerful predictors of morbidity because, in large measure, they are indicators of chronic, systemic inflammation. Further, both genetic variation and marital status served to moderate the association between neighborhood disorder and health. Finally, being married largely eliminated the probability that neighborhood disorder would combine with genetic vulnerability to increase inflammatory burden and perceived illness. Overall, the findings demonstrate the value of constructing integrated models that specify various biophysiological mechanisms that link social conditions to physical health.

Racial Differences in Clinical Outcomes for Metastatic Renal Cell Carcinoma Patients Treated With Immune-Checkpoint Blockade

“…Researchers postulate that alterations in the stress response from the hypothalamic-pituitary-adrenal (HPA) axis, leading to systemic hormonal changes, can impair immune-related functions and cause decreased tumor clearance amongst certain groups of patients ( 19 ). Neighborhood physical disorder is a condition often cited in bio-psychosocial models that links societal and systemic stressors to chronic inflammation which can drive immune dysregulation and poor health outcomes amongst disadvantaged communities ( 20 ). Additionally, researchers have also considered the disproportionate rates of vitamin D deficiency amongst African Americans as another potential contributor to healthcare disparities and sub-optimal immune function in this population ( 21 ).…”

Novel Methods of Identifying Individual and Neighborhood Risk Factors for Loss to Follow-Up After Ophthalmic Screening

“…Previous studies have found that neighborhood physical disorder influences a variety of health outcomes. [17][18][19][20] The hypothesized relationship between the built environment and health outcomes hinges on chronic stress as the mediating variable. 32 Neighborhood physical disorder did not significantly differ between participants who followed up and those who did not in univariate analysis or multivariate analysis.…”

“…Supplemental Table 2, Supplemental Digital Content 2, http://links.lww.com/IJG/A856 presents univariate analyses, which were performed for the 8 independent variables, which were selected by the study authors based on information collected from participants in the Real-Time Mobile Teleophthalmology screening study for individual-level factors and previously published literature on associations between chronic disease and neighborhood-level factors. [17][18][19][20][21] Neighborhood-level factors included census tract PCI quartiles, with the top quartile being the reference and physical disorder derived from the CANVAS audit system described above. PCI was assigned on an individual basis based on the Census tract of residency, whereas physical disorder was assigned based on an individual basis based on a 500-m radius around the participant's residential address.…”

The Impact of Harsh Parenting on the Development of Obesity in Adulthood: An Examination of Epigenetic/Gene Expression Mediators Among African American Youth

“…Acceptability of corporal punishment among African Americans may result in greater reports of "harsh parenting" that reflect some mixture of no nonsense parenting as well as exposure to abusive parenting (50). Poverty and stressful neighborhood characteristics are also associated with relatively harsher parenting strategies (51), increasing the likelihood of exposure to physical abuse among those raised in low-income communities (52). No nonsense parenting involves physical punishment and the use of physical restraint but occurs within the context of warmth and affection (53).…”