Neighborhood, individual factors cut racial disparities in heart health

Neighborhood- and individual-level factors attenuate racial disparities in cardiovascular health, according to a study published online Sept. 29 in JAMA Network Open.

Anika L. Hines, Ph.D., M.P.H., from the Virginia Commonwealth University School of Medicine in Richmond, and colleagues examined whether racial differences in ideal cardiovascular health (ICH) are attenuated by experiences with neighborhood- and individual-level stressors in a cross-sectional study examining data from 7,720 individuals from the Reasons for Geographic and Racial Differences in Stroke Study.

The researchers found compared with White participants, Black participants reported higher perceived stress (mean score, 3.2 versus 2.8) and more often reported discrimination (77 versus 24 percent). Poorer neighborhood physical environment and social cohesion were also reported by Black participants, and they more often reported that their neighborhoods were unsafe. The odds of having a high total ICH score (closer to ideal) were lower for Black versus White adults, overall and by gender (adjusted odds ratios, 0.53, 0.73, and 0.45 overall, for men, and for women, respectively).

In mediation analyses, neighborhood physical environment, neighborhood safety, neighborhood social cohesion, and discrimination attenuated the racial disparity in total ICH score (5.14, 6.27, 1.41, and 11.01 percent, respectively). The factors that most attenuated the racial disparity in total ICH scores were neighborhood safety and discrimination among men and women, respectively (12.32 and 14.37 percent, respectively).

"From a public health standpoint, these data suggest that interventional approaches that separately target neighborhood factors and discrimination by gender and race are warranted," the authors write.