Neighborhood Environments and Coronary Heart Disease: A Multilevel Analysis

@article{diez-roux_1997, 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.}, author = {Diez-Roux, Ana V. and Nieto, Javier F. and Muntaner, Carles and Tyroler, Herman A. and Comstock, George W. and Shahar, Eyal and Cooper, Lawton S. and Watson, Robert L. and Szklo, Moyses}, citeulike-article-id = {3396386}, comment = {Study investigating the neighbourhood context for risk factors of coronary heart disease (CHD), in four communities of the USA. Concluded that both neighbourhood and individual social class indicators played a part in shaping CHD risk. ``Previous studies conducted in the United States found that area socioenvironmental characteristics are related to CHD mortality but were unable to determine whether these associations persist after controlling for individual-level variables.'' (p.53) }, journal = {Am. J. Epidemiol.}, keywords = {area, chd, communities, deprivation, ethnicity, multilevel, race, usa}, month = {July}, number = {1}, pages = {48--63}, posted-at = {2008-10-11 14:06:31}, priority = {0}, title = {Neighborhood Environments and Coronary Heart Disease: A Multilevel Analysis}, url = {http://aje.oxfordjournals.org/cgi/content/abstract/146/1/48}, volume = {146}, year = {1997} }

TY - JOUR ID - diez-roux_1997 L3 - citeulike-article-id:3396386 N2 - 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. IS - 1 JF - Am. J. Epidemiol. EP - 63 TI - Neighborhood Environments and Coronary Heart Disease: A Multilevel Analysis VL - 146 SP - 48 KW - area KW - chd KW - communities KW - deprivation KW - ethnicity KW - multilevel KW - race KW - usa N1 - Study investigating the neighbourhood context for risk factors of coronary heart disease (CHD), in four communities of the USA. Concluded that both neighbourhood and individual social class indicators played a part in shaping CHD risk. ``Previous studies conducted in the United States found that area socioenvironmental characteristics are related to CHD mortality but were unable to determine whether these associations persist after controlling for individual-level variables.'' (p.53) AU - Diez-Roux, Ana AU - Nieto, Javier AU - Muntaner, Carles AU - Tyroler, Herman AU - Comstock, George AU - Shahar, Eyal AU - Cooper, Lawton AU - Watson, Robert AU - Szklo, Moyses PY - 1997/07/01/ UR - http://aje.oxfordjournals.org/cgi/content/abstract/146/1/48 ER -