Race/ethnicity, neighborhood socioeconomic status and cardio-metabolic risk. (August 2020) - Merkin, Sharon Stein
Abstract: Objective: To determine the association between neighborhood socioeconomic status (NSES) and cardio-metabolic risk and whether this relationship differs by race/ethnicity. Methods: Participants in the Multi-Ethnic Study of Atherosclerosis (n = 5750), ages 45–84 years, from 6 US counties, including 5 examinations from 2000 to 2012. We calculated a modified allostatic load (AL) index, indicating cardio-metabolic risk. NSES score included census-derived measures at census tract of residence. Mixed effects growth curve models were used to assess linear and non-linear associations between NSES and AL at baseline and over time. Results: Higher NSES was associated with lower AL across race/ethnic groups; considering NSES quintiles, significant associations were found only for the highest NSES quintiles (difference of -0.86 and -1.15 for white and Hispanic participants) vs. the lowest. We found no significant association between NSES and change in AL over time. Discussion: Our findings suggest that the relationship between NSES and AL reflects the health benefits of living in the most advantaged neighborhoods. Public health implications: Understanding the impact of higher NSES on health effects may help identify interventions to effectively target high risk neighborhoods. Highlights: These findings confirm the association between high NSES and low AL; pattern is similar across race/ethnic groups. The relationship between NSES and AL reflects the health benefits of living in the most advantaged neighborhoods. Identifying neighborhood factors that impact health is crucial to effectively target high risk neighborhoods.