Association of census-tract level gentrification and income inequality with 6-year incidence of metabolic syndrome in the Hispanic Community Health Study/Study of Latinos, an epidemiologic cohort study

Abstract

BackgroundMetabolic syndrome varies by socio-demographic characteristics, with younger (18–29 years) and older (50–69 years) Hispanic/Latino having higher prevalence compared to other groups. While there is substantial research on neighborhood influences on cardiometabolic health, there are mixed findings regarding the effects of gentrification and few studies have included Hispanic/Latinos. The role of neighborhood income inequality on metabolic health remains poorly understood. ObjectivesExamined associations of neighborhood gentrification and income inequality with metabolic syndrome (MetSyn) using data from the Hispanic Community Health Study/Study of Latinos (HCHS/SOL). Design, Setting and ParticipantsThe HCHS/SOL is a community-based cohort of adults of Hispanic/Latinos (aged 18–74). Analyses included 6710 adults who did not meet criteria for MetsS at baseline (2008–2011) and completed the visit 2 examination (2014–2017). Poisson regressions estimated odds ratios (IRR) and 95% confidence intervals (CI) for neighborhood gentrification and change in income inequality with MetSyn incidence. Main outcome and exposure measuresGentrification was measured with an index that included changes (2000 to 2006–2010) in education, poverty, and income. Change in neighborhood income inequality (2005–2009 to 2012–2016) was measured using the Gini coefficient of income distribution. MetSyn was defined using National Cholesterol Education Program Adult Treatment Panel III criteria. ResultsAmong 6647 Hispanic/Latino adults, 23% (N = 1530) had incident MetSyn. In models adjusted for socio-demographic, health insurance status, and neighborhood characteristics, gentrification (IRR, 1.00, 95%CI, 0.96–1.03) and income inequality change (IRR, 1.00, 95%CI, 0.99–1.00) were not associated with MetSyn at visit 2. There was no association between cross-sectional income inequality (2005–2009) and MetSyn at visit 2 (IRR, 0.97, 95%CI, 0.82–1.15). ConclusionNeighborhood gentrification and income inequality change were not associated with incidence of MetSyn over 6 years among Hispanic/Latino adults. This study demonstrated that income-based residential changes alone may not be sufficient to explain neighborhood influences on health outcomes among this population.