Abstract 20: Neighborhood Social Cohesion and Cvd Risk Factors in Lesbian, Gay, and Bisexual Adults

Abstract

Introduction: Greater perceived neighborhood social cohesion (degree of connectedness among neighbors) has been associated with lower rates of cardiovascular disease (CVD) risk factors and incident CVD. Although sexual minorities (e.g., gay, lesbian, and bisexual) report lower neighborhood social cohesion and higher CVD risk than their heterosexual peers, there is limited population-based evidence regarding the association of neighborhood factors with CVD risk in sexual minorities. Hypothesis: Better neighborhood social cohesion would be associated with lower odds of CVD risk factors in sexual minorities. Methods: We used data from the National Health Interview Survey (2013-2018), a nationally representative sample of U.S. adults. To assess neighborhood social cohesion participants rated the degree to which they agreed with 4 statements (on a 4-point Likert scale). Responses were summed and reverse-coded so that higher scores indicated greater neighborhood social cohesion (range = 4-16). We assessed six self-reported CVD risk factors: current tobacco use, physical inactivity, short sleep duration (≤ 6 h), obesity (BMI ≥ 30kg/m2), and diagnosis of hypertension and/or diabetes. Sex- and sexual identity-stratified logistic regression models were used to examine the association of neighborhood social cohesion and CVD risk factors. Models were adjusted for demographic characteristics and length of time living in neighborhood. Results: The sample consisted of 166,588 participants (97% heterosexual, 2% gay/lesbian, 1% bisexual). Gay (M = 11.9, p <0.001) and bisexual men (M = 11.5, p <0.001) had lower mean social cohesion scores than heterosexual men (M = 12.5). Similarly, lesbian (M = 11.9, p <0.01) and bisexual women (M = 11.1, p <0.001) had lower mean social cohesion scores than heterosexual women (M = 12.4). Among heterosexual participants higher neighborhood social cohesion scores were associated with lower odds of reporting all CVD risk factors. Greater neighborhood social cohesion was associated with lower odds of physical inactivity in lesbian women (AOR 0.95, 95% CI [0.90-0.99]) and lower odds of short sleep duration in lesbian (AOR 0.88, 95% CI [0.84-0.93]) and bisexual women (AOR 0.93, 95% [0.89-0.98]). Greater neighborhood social cohesion was associated with lower odds of obesity in bisexual men (AOR 0.90, 95% CI [0.82-0.99]). Conclusions: Findings suggest that neighborhood social cohesion may be a determinant of CV health in sexual minorities, particularly those that identify as female. Longitudinal studies to examine how neighborhood social cohesion and other neighborhood factors (e.g., violence, safety, and walking environment) influence CVD risk over time in this population are needed.