Abstract 001: The Association of Neighborhood Characteristics and Ideal Cardiovascular Health in the Multi-Ethnic Study of Atherosclerosis (MESA)
Authors: Unger Erin D , Diez-Roux Ana , Lloyd-Jones Donald , Mujahid Mahasin , Nettleton Jennifer , Ning Hongyan , Allen Norrina 
Published: July 2021

Background:
The American Heart Association's 2020 Impact Goals introduced the concept of “ideal cardiovascular (CV) health.” While previous studies have examined individual risk factors, little is known about the relationship between neighborhood environment and ideal CV health.

Methods:
We analyzed data from the MESA baseline exam (2000-2002). Ideal, intermediate and poor levels of cholesterol, BMI, diet, physical activity, fasting glucose, blood pressure and smoking were defined according to the AHA 2020 Strategic Goals and summed accordingly. Overall ideal CV health score was divided into quartiles. Neighborhood characteristics included the number of favorable and unfavorable food stores and physical activity facilities within ½ mile, 5 factors based on census data describing neighborhood socioeconomic status and estimates of aesthetic quality, walking environment, healthy food availability, safety and social cohesion for census tracts based on the MESA Community Survey. Logistic regression was used to determine the association of each neighborhood characteristic with the top quartile of ideal CV health adjusted for age, sex, race/ethnicity, education, income and site. Each neighborhood characteristic was analyzed separately.

Results:
6,047 MESA participants were included; 1,410 in the top quartile of ideal CV health score. Individuals with the highest ideal CV health scores were younger (60 vs 63 yrs), more likely to be male (59% vs 50%), Caucasian (43% vs 39%), and had higher education (49% vs 32% had college edu). Individuals from neighborhoods with more food stores, physical activity facilities, and a more favorable walking, food and safety environment were more likely to be in the top quartile of ideal CV health (
table
).

Conclusion:
This study suggests that ideal CV health score is associated with multiple different neighborhood characteristics demonstrating the importance of local environment. As such, this analysis can serve as the foundation for targeting future efforts at promoting ideal CV health.

Table

Odds of being in top quartile of Ideal Cardiovascular Health Score

Neighborhood Characteristics
Unadjusted OR (95% CI)

Adjusted
*
OR (95% CI)

½ mile to favorable food stores

1.01 (1.00-1.02)

1.03 (1.02-1.04)

½ mile to unfavorable food stores

1.01 (1.00-1.01)

1.01 (1.00-1.01)

½ mile to physical activity facilities

1.02 (1.01-1.02)

1.02 (1.01-1.02)

Aesthetic quality estimate
1.12 (0.96-1.31)
0.83 (0.68-1.01)

Walking environment estimate

1.82 (1.45-2.30)

2.16 (1.79-2.62)

Healthy food environment estimate

2.18 (1.91-2.48)

1.66 (1.41-1.95)

Safety estimate

1.69 (1.43-1.98)

1.28 (1.05-1.57)

Social cohesion
0.82 (0.62-1.07)

0.68 (0.43-0.86)

Neighborhood SES
**

Poverty

0.84 (0.73-0.98)

1.09 (0.92-1.29)

Education/Occupation

0.80 (0.73-0.88)

0.81 (0.73-0.90)

Immigrants/Crowding

1.52 (1.40-1.64)

1.24 (1.11-1.39)

African American/ Family Structure

0.80 (0.71-0.90)

0.92 (0.80-1.06)

Residential Stability
1.08 (0.96-1.20)
0.99 (0.88-1.12)

*

adjusted for age, gender, race/ethnicity, income, education, site

**

all five factors were included in the same model