title: Perceived neighbourhood social cohesion and myocardial infarction.
abstract: BACKGROUND
  The main strategy for alleviating heart disease has been to target individuals and encourage them to change their health behaviours. Although important, emphasis on individuals has diverted focus and responsibility away from neighbourhood characteristics, which also strongly influence people's behaviours. Although a growing body of research has repeatedly demonstrated strong associations between neighbourhood characteristics and cardiovascular health, it has typically focused on negative neighbourhood characteristics. Only a few studies have examined the potential health enhancing effects of positive neighbourhood characteristics, such as perceived neighbourhood social cohesion.
  
  
  METHODS
  Using multiple logistic regression models, we tested whether higher perceived neighbourhood social cohesion was associated with lower incidence of myocardial infarction. Prospective data from the Health and Retirement Study--a nationally representative panel study of American adults over the age of 50--were used to analyse 5276 participants with no history of heart disease. Respondents were tracked for 4 years and analyses adjusted for relevant sociodemographic, behavioural, biological and psychosocial factors.
  
  
  RESULTS
  In a model that adjusted for age, gender, race, marital status, education and total wealth, each SD increase in perceived neighbourhood social cohesion was associated with a 22% reduced odds of myocardial infarction (OR=0.78, 95% CI 0.63 to 0.94. The association between perceived neighbourhood social cohesion and myocardial infarction remained even after adjusting for behavioural, biological and psychosocial covariates.
  
  
  CONCLUSIONS
  Higher perceived neighbourhood social cohesion may have a protective effect against myocardial infarction.
authors.affiliation: Department of Psychology, University of Michigan, Ann Arbor, Michigan, USA.
authors.forename: Eric S
authors.initials: ES
authors.lastname: Kim
authors.affiliation: Department of Psychology, University of Michigan, Ann Arbor, Michigan, USA.
authors.forename: Armani M
authors.initials: AM
authors.lastname: Hawes
authors.affiliation: Department of Psychology, University of Michigan, Ann Arbor, Michigan, USA Institute for Social Research, University of Michigan, Ann Arbor, Michigan, USA.
authors.forename: Jacqui
authors.initials: J
authors.lastname: Smith
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D015986:Confounding Factors, Epidemiologic; D005260:Female; D015438:Health Behavior; D006304:Health Status; D006306:Health Surveys; D006801:Humans; D015994:Incidence; D007407:Interviews as Topic; D008297:Male; D008603:Mental Health; D008875:Middle Aged; D055361:Multilevel Analysis; D009203:Myocardial Infarction / Q000453:epidemiology / Q000517:prevention & control* / Q000523:psychology; D010465:Perception; D011446:Prospective Studies; D065840:Protective Factors; D012111:Residence Characteristics; D057566:Self Report; D012931:Social Environment; D012959:Socioeconomic Factors; D014481:United States / Q000453:epidemiology
keywords: Ageing; Epidemiology of Ageing; Epidemiology of Cardiovascular Disease; Psychosocial Factors; Public Health