Abstract 015: Better Neighborhood Characteristics Are Associated with Ideal Cardiovascular Health Among Blacks: Results From the Morehouse-Emory Cardiovascular (MECA) Center for Health Equity
Authors: Kim Jeong Hwan , Baltrus Peter , Topel Matthew L , Liu Chang , Ko Yi-An , Mujahid Mahasin , Vaccarino Viola , Sims Mario , Mubasher Mohamed , Khan Ahsan , Ejaz Kiran , Searles Charles , Dunbar Sandra B , Pemu Priscilla , Taylor Herman , Quyyumi Arshed A , Lewis Tené T 
Published: March 2019

Introduction:
Intra-racial heterogeneity in cardiovascular health (CVH) among Blacks is understudied, and more research is needed to identify factors promoting CVH among Blacks. Neighborhood environment is increasingly recognized as an important determinant of CV risk and health, Yet whether specific features of neighborhood physical and social environments may promote CV resilience among Blacks has been underexplored.

Hypothesis:
Better neighborhood characteristics are associated with ideal CVH among Black adults, measured as Life’s Simple 7 (LS7) scores.

Methods:
We recruited 392 Black adults (age 53 ± 10, 39% male) without known CV disease in Atlanta, GA, who resided in 199 residential neighborhood (defined as census tracts). Seven neighborhood domains were assessed via questionnaire: aesthetic quality, walking environment, safety, food access, social cohesion, activity with neighbors, and violence. CVH was determined by LS7 scores calculated from measured blood pressure, glucose, cholesterol, body mass index (BMI), and self-reported exercise, diet, and smoking, and categorized into poor (0-8), intermediate (9-10), and ideal (11-14). Multinomial logistic regression was used to examine the association between neighborhood characteristics and the odds of intermediate/ideal CVH categories compared to poor CVH after adjustment for age, gender, household income, education, marital status, and employment status.

Results:
A total of 53 (14%), 110 (28%), and 229 (58%) participants had ideal, intermediate, and poor LS7 scores, respectively. Better scores in the neighborhood domains of social cohesion and activity with neighbors were significantly associated with higher adjusted odds of ideal LS7 scores (OR 1.95, 95% CI [1.32 - 2.90] and 1.65 [1.16 - 2.35] per 1 standard deviation [SD] increase in respective scores). Specifically, better scores in social cohesion were associated with higher odds of ideal CVH in exercise (OR 1.73 [1.16 - 2.59]), diet (OR 1.99 [1.14 - 3.48]), and BMI (OR 1.51 [1.09 - 2.09]); better scores in activity with neighbors were also similarly associated with higher odds of ideal CVH in exercise (OR 1.47 [0.99 - 2.19]), diet (OR 2.37 [1.32 - 4.26]), and BMI (OR 1.44 [1.05 - 1.96]; per 1 SD in respective scores). Aesthetic quality, walking environment, safety, food access, and violence were not significantly associated with overall CVH categories in the adjusted models.

Conclusion:
More desirable neighborhood characteristics, particularly social cohesion and activity with neighbors, were associated with better CVH among Black adults. Further research is needed to investigate whether interventions to improve neighborhood qualities lead to better CVH in Blacks.