Abstract
BackgroundLiving in a socially deprived neighborhood is associated with lifestyle risk factors, e.g., smoking, physical inactivity and unhealthy diet, as well as an increased risk of cardiovascular disease, i.e., coronary heart disease and stroke. The aim was to study whether the odds of cardiovascular disease vary with the neighbourhood availability of potentially health-damaging and health-promoting resources.MethodsA nationwide sample of 2 040 826 men and 2 153 426 women aged 35–80 years were followed for six years for first hospitalization of coronary heart disease or stroke. Neighborhood availability of health-damaging resources (i.e., fast-food restaurants and bars/pubs) and health-promoting resources (i.e., health care facilities and physical activity facilities) were determined by use of geographic information systems (GIS).ResultsWe found small or modestly increased odds ratios (ORs) for both coronary heart disease and stroke, related to the availability of both health-damaging and health-promoting resources. For example, in women, the unadjusted OR (95 % confidence interval) for stroke in relation to availability of fast-food restaurants was 1.18 (1.15–1.21). Similar patterns were observed in men, with an OR = 1.08 (1.05–1.10). However, the associations became weaker or disappeared after adjustment for neighborhood-level deprivation and individual-level age and income.ConclusionsThis six year follow-up study shows that neighborhood availability of potentially health-damaging as well as health-promoting resources may make a small contribution to the risk of coronary heart disease and stroke. However, most of these associations were attenuated or disappeared after adjustment for neighborhood-level deprivation and individual-level age and income. Future studies are needed to further examine factors in the causal pathway between neighborhood deprivation and cardiovascular disease.Electronic supplementary materialThe online version of this article (doi:10.1186/s12889-016-3293-5) contains supplementary material, which is available to authorized users.
Highlights
Living in a socially deprived neighborhood is associated with lifestyle risk factors, e.g., smoking, physical inactivity and unhealthy diet, as well as an increased risk of cardiovascular disease, i.e., coronary heart disease and stroke
Incidence of Cardiovascular disease (CVD) increased with higher level of neighborhood deprivation in all subgroups; there were no large differences in relation to availability of the four resources
The odds ratios (OR) in relation to high neighborhood deprivation compared to low deprivation was 1.39 (1.35–1.42) for coronary heart disease (CHD), and 1.28 (1.24–1.32) for stroke, adjusted for individual-level age and income
Summary
Living in a socially deprived neighborhood is associated with lifestyle risk factors, e.g., smoking, physical inactivity and unhealthy diet, as well as an increased risk of cardiovascular disease, i.e., coronary heart disease and stroke. Studies linking neighborhood environment and CVD risk factors have yielded mixed results and have most often been limited by cross-sectional designs and same-source bias [6, 7, 13, 14]. It has been debated whether deprived neighborhoods
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