Abstract 14103: Neighborhood Environmental Burden and Cardiovascular Health in the United States

Abstract

Introduction: Little is known about the association between cumulative environmental burden and cardiovascular health. Methods: This national study of 71,659 US census tracts linked the CDC environmental burden index and social vulnerability index (SVI) to 2020 PLACES. Mixed-effects linear regression models were used to determine associations between cumulative environmental burden (air pollution, hazardous/toxic sites, built environment, transportation infrastructure, water pollution) and cardiovascular risk factors (hypertension, diabetes, obesity) and diseases (coronary heart disease, stroke) after adjustment for age, sex, SVI, rurality, region, and health care access. Results: Neighborhoods with the highest environmental burden (quartile 4), compared to those with the lowest burden (quartile 1), had greater SVI scores (0.64 vs 0.42) and a higher proportion of racial/ethnic minorities (34% vs 12%). After adjustment, quartile 4 neighborhoods had significantly higher rates of cardiovascular risk factors than quartile 1 neighborhoods, including hypertension (32.8% vs 32.1%, adjusted difference: 0.84% [95% CI: 0.71-0.98]), diabetes (12.2% vs 10.7%, 0.62% [0.53-0.70]), and obesity (33.6% vs 30.9%, 0.77% [0.60-0.94]). Similarly, quartile 4 neighborhoods had higher rates of cardiovascular diseases (Figure) . Results were consistent after geospatial- and covariate-based matching of quartile 4 and 1 neighborhoods. Associations between increasing environmental burden quartiles and cardiovascular risk factors and diseases were significantly more pronounced in most versus least socially vulnerable neighborhoods. Conclusion: Across US neighborhoods, cumulative environmental burden was dose-dependently associated with higher rates of cardiovascular risk factors and diseases, particularly in socially vulnerable communities. Efforts addressing poor environmental conditions may improve cardiovascular health and reduce inequities.