Abstract P202: Optimism Moderates The Effects Of Neighborhood Disadvantage On Incident Heart Failure Among African-Americans In The Jackson Heart Study (JHS) And Atherosclerosis Risk In Communities (ARIC) Study

Abstract

Background: African-Americans experience a disproportionate burden of heart failure. Although previous research has identified neighborhoods as an important contributor to these disparities, less is understood about how psychosocial resilience factors, such as optimism, may provide protection from the effects of neighborhood disadvantage on heart failure risk. We tested the hypothesis that higher levels of optimism will attenuate the associations between greater neighborhood disadvantage and higher incidence of heart failure. Methods: Among 1,448 African-Americans dually enrolled in two community-based cohorts in Jackson, Mississippi—JHS and the ARIC study—who were free of heart failure as of January 1, 2000, 459 failure events classified by reviewer panel accrued through December 31, 2019. Multi-level age- and sex-adjusted Cox regression models with interaction terms were used to examine whether individual-level optimism moderated the associations of four measures of census tract-level neighborhood socioeconomic and social environment characteristics (the national Area Deprivation Index (ADI), a JHS neighborhood disadvantage score, racial residential segregation, and perceived physical disorder) on individual-level incident hospitalized heart failure. Results: Optimism moderated the associations of some neighborhood disadvantage measures (ADI and JHS neighborhood disadvantage score) on hospitalized heart failure risk (Table). Compared to participants reporting the lowest level of optimism, those in the highest tertile had 12%, 6%, 16%, and 9% lower rates of heart failure associated with increasing neighborhood disadvantage, respectively for each exposure. Interaction estimates for racial residential segregation and perceived physical disorder did not reach statistical significance. Conclusions: Optimism may provide resilience to the detrimental effects of neighborhood disadvantage on risk for heart failure.