Abstract 14863: Poor Neighborhood Economic Conditions and Perceived Neighborhood Safety are Associated with Cardiometabolic Risk Factors and Insulin Resistance among African Americans in the Jackson Heart Study
Introduction: Cardiometabolic risk factors (CMRs) are prevalent among African Americans (blacks) in the southeastern United States (US) and may contribute to their relatively higher rates of heart disease morbidity compared to other Americans. The extent to which neighborhood economic and social environments are associated with CMRs among blacks is poorly understood.
Methods and Results: We examined the association between poor neighborhood economic conditions (NEC), perceived neighborhood safety and CMRs among 3,909 blacks living in Mississippi who participated in the Jackson Heart Study cohort (JHS) [2000-2004]. We measured eight CMRs among 3,909 participants without known diabetes, namely, the metabolic syndrome (used Adult Treatment Panel III guidelines); its five constituent parts (elevated triglycerides, elevated fasting glucose, elevated blood pressure, low HDL-C, elevated waist circumference); the homeostasis model assessment of insulin resistance (HOMA-IR) and elevated C-reactive protein (defined as > 3.0 mg/L). Factor analysis was used to construct a measure of poor NEC from three conditions in the 2000 US Census: census tract poverty, unemployment, and car ownership prevalence. Perceived neighborhood safety, diet, exercise, smoking, family income and education were assessed via survey. We estimated prevalence ratios (PRs) using log binomial regression with a random intercept model for neighborhood effects. Poor NEC and perceived neighborhood safety were correlated (p = 0.01). JHS participants had high exposure to poor NEC (73%) and 41% perceived their neighborhoods as unsafe. After adjustment for potential confounders, poor NEC were associated with the metabolic syndrome only in women (PR 1.13, 95% CI 1.01, 1.27). Among men, lack of perceived safety was associated with elevated glucose (PR 1.30, 95% CI 1.02, 1.66) and HOMA-IR (PR 1.28, 95% CI 1.11, 1.47), whereas in women with elevated glucose (PR 1.36, 95% CI 1.03, 1.80) and waist circumference (PR 1.06, 95% CI 1.02, 1.11).
Conclusions: This analysis suggests that poor NEC and lack of perceived neighborhood safety may be targets for intervention to reduce the prevalence of specific cardiometabolic risk factors and ultimately heart disease among blacks.
- © 2012 by American Heart Association, Inc.