Abstract P082: Neighborhoods and Racial/Ethnic Differences in Ideal Cardiovascular Health: The Multi-Ethnic Study of Atherosclerosis (MESA)

Abstract

Introduction: Neighborhood environments have been investigated in relation to individual cardiovascular disease risk. However, few studies have examined the contribution of neighborhood environments to racial/ethnic differences in cardiovascular health (CVH). Hypothesis: We hypothesized that there would be significant racial/ethnic differences in ideal CVH and these differences would be reduced after adjustment for neighborhood factors. Methods: We used data from the MESA baseline examination (2000-2002; mean age=62, SD=10). Ideal cardiovascular health was defined using guidelines from the American Heart Association 2020 Strategic Impact Goals. We examined seven CVH indicators (blood pressure, fasting glucose, cholesterol, body mass index, diet, physical activity, and smoking) and three summary measures (health factors, health behaviors, overall CVH). We compared racial/ethnic differences in ideal CVH before and after adjustment for neighborhood factors (socioeconomic, physical activity, healthy food, social environment) using logistic regression and hybrid fixed effects models. Neighborhood-level data were obtained from various administrative data sources including the Neighborhood Community Survey and linked to MESA study participants. Results: Among the 5,263 participants in our analytic sample, 215 (4.1%) had ideal CVH. This proportion varied across racial/ethnic groups (6.6% for whites, 2% for African Americans, and 2.1% for Hispanics). Significant racial/ethnic differences were present for all indicators (excluding physical activity and diet) and summary measures of ideal CVH, independent of confounders. Additional adjustments for neighborhood factors produced modest reductions in racial/ethnic differences. Conclusion: Neighborhood factors may play a role in shaping racial/ethnic health disparities in CVH. Future research is necessary to better understand the impact of neighborhood context on CVH disparities over the life course.