Neighborhood Environments and Coronary Heart Disease: A Multilevel Analysis

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ID: 305934
1997
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Abstract
The authors investigated whether neighborhood socioeconomic charactenstics are associated with coronary heart disease prevalence and risk factors, whether these associations persist after adjustment for individual-level social class indicators, and whether the effects of individual-level indicators vary across neighborhoods. The study sample consisted of 12,601 persons in four US communities (Washington County, Maryland; Forsyth County, North Carolina; Minneapolis, Minnesota; and Jackson, Mississippi) participating in the baseline examination of the Atherosclerosis Risk in Communities Study (1987–1989). Neighborhood characteristics were obtained from 1990 US Census block-group measures. Multilevel models were used to estimate associations with neighborhood variables after adjustment for individual-level indicators of social class. Living in deprived neighborhoods was associated with increased prevalence of coronary heart disease and increased levels of risk factors, with associations generally persisting after adjustment for individual-level variables. Inconsistent associations were documented for serum cholesterol and disease prevalence in African-American men. For Jackson African-American men living in poor neighborhoods, coronary heart disease prevalence decreased as neighborhood characteristics worsened. Additionally, in African-American men from Jackson, low social class was associated with Increased serum cholesterol in "richer" neighborhoods but decreased serum cholesterol in "poorer" neighborhoods. Neighborhood environments may be one of the pathways through which social structure shapes coronary heart disease risk. Am J Epidemiol 1997;146: 48–63.
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openalex_W2124041619 Use this key to autocite in the manuscript while using SciMatic Manuscript Manager or Thesis Manager
Authors Ana V. Diez–Roux, F. Javier Nieto, Carles Muntañer, H. A. Tyroler, G W Comstock, Eyal Shahar, LAWTON S. COOPER, R. L. Watson, Moysés Szklo
Journal american journal of epidemiology
Year 1997
DOI
10.1093/oxfordjournals.aje.a009191
URL
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