Abstract 03: High Neighborhood Incarceration Rate is Associated With Poor Cardiovascular Risk Profiles in Non-incarcerated Black Individual

Abstract

Introduction: Over 7 million Americans are current or former prisoners. Blacks are imprisoned at rates 4 to 10 times greater than Whites. While personal incarceration history is associated with greater all-cause mortality and incident cardiovascular disease (CVD), the impact of high neighborhood rates of incarceration on CVD risk in non-incarcerated individuals is unknown. Hypothesis: High neighborhood incarceration rate, defined as the upper quartile, is associated with poor individual CVD risk profile. Methods: A total of 1368 subjects from the Atlanta area (mean age 49 ± 10 years, 62% female [n=850], 41% Black [n=560]) were recruited from two community cohorts. Zip codes were used to link neighborhood incarceration and crime rates to individual pooled risk scores (ASCVD), risk factors for CVD including hypertension, dyslipidemia and impaired fasting glucose (IFG), and biomarkers including high-sensitivity C-reactive protein (hsCRP) and the homeostatic model assessment for insulin resistance (HOMA-IR). Results: High neighborhood incarceration rate was associated with high ASCVD risk score (OR=1.41, 95% CI=1.02, 1.95), hypertension (OR=1.48, 95% CI=1.05, 2.07) and dyslipidemia (OR=1.45, 95% CI=1.04, 2.04), after controlling for relevant demographic, socioeconomic and behavioral covariates. Tests for interaction with race were significant: Black individuals living in areas with high incarceration rates were more likely to have hypertension (OR=1.63, 95% CI=1.03, 2.58), dyslipidemia (OR=1.80, 95% CI=1.15, 2.83), IFG (OR=1.77, 95% CI=1.04, 3.03), and elevated HOMA-IR (OR=2.04, 95% CI=1.20, 3.47); Whites were more likely to have an elevated hsCRP (OR=1.81, 95% CI=1.02, 3.22). Conclusions: In conclusion, high neighborhood incarceration rate is associated with a worse CVD risk profile; this effect was more pronounced in Blacks. Neighborhood exposure to increased incarceration rates, particularly in Black communities, represents an additional health disparity that warrants further investigation.