Abstract 19073: Geographic Classification Scheme for High-Risk Neighborhoods for Cardiovascular Disease in Texas

Abstract

There is substantial evidence that neighborhood characteristics have a significant impact on residents’ health outcomes. Our intent in this study was to create a classification system based on differences between high-risk neighborhoods for cardiovascular health in Texas. To accomplish this goal, we drew a total sample of 13 million cases of cardiovascular disease treatment from the 2006 Texas Hospital Inpatient Discharge Public Use Data File. These cases were then geo-coded to Zip Code Tabulation Areas (ZCTA’s) and age-adjusted hospitalization rates were calculated for each ZCTA. The top quartile of all ZCTA’s were retained for a factor and k-means cluster analysis, which used ten carefully selected socio-economic variables, to differentiate between high risk neighborhoods for cardiovascular disease. Based on this analysis, we identified four types of high-risk neighborhoods in the state. These include largely white areas in rural Texas; inner-city African-American neighborhoods; heavily Hispanic neighborhoods in large cities and the Rio Grande Valley; and diverse, working-class suburbs. . These clusters demonstrate the complexity of neighborhood effects on cardiovascular disease, as well as the linkages between race and poverty, and hospital admissions. In conclusion, in order for the American Heart Association to reach its goal of reducing cardiovascular disease and death by 20 percent by 2020, outreach and policy must be crafted to reach particular groups, and be delivered in ways that reach those particular types of neighborhoods. The classification system presented in this paper provides a framework for just such a project.