title: Change in Neighborhood Characteristics and Change in Coronary Artery Calcium: A Longitudinal Investigation in the MESA (Multi-Ethnic Study of Atherosclerosis) Cohort.
abstract: Although some evidence shows that neighborhood deprivation is associated with greater subclinical atherosclerosis, prior studies have not identified what aspects of deprived neighborhoods were driving the association.
  
  
  
  We investigated whether social and physical neighborhood characteristics are related to the progression of subclinical atherosclerosis in 5950 adult participants of the MESA (Multi-Ethnic Study of Atherosclerosis) during a 12-year follow-up period. We assessed subclinical disease using coronary artery calcium (CAC). Neighborhood features examined included density of recreational facilities, density of healthy food stores, and survey-based measures of availability of healthy foods, walking environment, and social environment. We used econometric fixed-effects models to investigate how change in a given neighborhood exposure is related to simultaneous change in subclinical atherosclerosis.
  
  
  
  Increases in density of neighborhood healthy food stores were associated with decreases in CAC (mean changes in CAC Agatston units per 1-SD increase in neighborhood exposures, -19.99; 95% confidence interval, -35.21 to -4.78) after adjustment for time-varying demographic confounders and computed tomography scanner type. This association remained similar in magnitude after additional adjustment for time-varying behavioral risk factors and depression. The addition of time-varying biomedical factors attenuated associations with CAC slightly (mean changes in CAC per 1-SD increase in neighborhood exposures, -17.60; 95% confidence interval, -32.71 to -2.49). Changes across time in other neighborhood measures were not significantly associated with within-person change in CAC.
  
  
  
  Results from this longitudinal study provide suggestive evidence that greater access to neighborhood healthy food resources may slow the development of coronary atherosclerosis in middle-aged and older adults.
authors.affiliation: From Department of Public Health, Grand Valley State University, Grand Rapids, MI (J.J.W.); Departments of Epidemiology (E.A., S.D.A.) and Biostatistics (B.S.), University of Michigan School of Public Health, Ann Arbor; Departments of Environmental and Occupational Health Sciences (A.L.D.) and Epidemiology (A.H.), University of Washington School of Public Health, Seattle; Department of Medicine, University of Wisconsin School of Medicine and Public Health, Madison (J.H.S., M.C.T.); and Department of Epidemiology and Biostatistics, Dornsife School of Public Health, Drexel University School of Public Health, Philadelphia, PA (A.V.D.R.). wingje@gvsu.edu.
authors.forename: Jeffrey J
authors.initials: JJ
authors.lastname: Wing
authors.affiliation: From Department of Public Health, Grand Valley State University, Grand Rapids, MI (J.J.W.); Departments of Epidemiology (E.A., S.D.A.) and Biostatistics (B.S.), University of Michigan School of Public Health, Ann Arbor; Departments of Environmental and Occupational Health Sciences (A.L.D.) and Epidemiology (A.H.), University of Washington School of Public Health, Seattle; Department of Medicine, University of Wisconsin School of Medicine and Public Health, Madison (J.H.S., M.C.T.); and Department of Epidemiology and Biostatistics, Dornsife School of Public Health, Drexel University School of Public Health, Philadelphia, PA (A.V.D.R.).
authors.forename: Ella
authors.initials: E
authors.lastname: August
authors.affiliation: From Department of Public Health, Grand Valley State University, Grand Rapids, MI (J.J.W.); Departments of Epidemiology (E.A., S.D.A.) and Biostatistics (B.S.), University of Michigan School of Public Health, Ann Arbor; Departments of Environmental and Occupational Health Sciences (A.L.D.) and Epidemiology (A.H.), University of Washington School of Public Health, Seattle; Department of Medicine, University of Wisconsin School of Medicine and Public Health, Madison (J.H.S., M.C.T.); and Department of Epidemiology and Biostatistics, Dornsife School of Public Health, Drexel University School of Public Health, Philadelphia, PA (A.V.D.R.).
authors.forename: Sara D
authors.initials: SD
authors.lastname: Adar
authors.affiliation: From Department of Public Health, Grand Valley State University, Grand Rapids, MI (J.J.W.); Departments of Epidemiology (E.A., S.D.A.) and Biostatistics (B.S.), University of Michigan School of Public Health, Ann Arbor; Departments of Environmental and Occupational Health Sciences (A.L.D.) and Epidemiology (A.H.), University of Washington School of Public Health, Seattle; Department of Medicine, University of Wisconsin School of Medicine and Public Health, Madison (J.H.S., M.C.T.); and Department of Epidemiology and Biostatistics, Dornsife School of Public Health, Drexel University School of Public Health, Philadelphia, PA (A.V.D.R.).
authors.forename: Andrew L
authors.initials: AL
authors.lastname: Dannenberg
authors.affiliation: From Department of Public Health, Grand Valley State University, Grand Rapids, MI (J.J.W.); Departments of Epidemiology (E.A., S.D.A.) and Biostatistics (B.S.), University of Michigan School of Public Health, Ann Arbor; Departments of Environmental and Occupational Health Sciences (A.L.D.) and Epidemiology (A.H.), University of Washington School of Public Health, Seattle; Department of Medicine, University of Wisconsin School of Medicine and Public Health, Madison (J.H.S., M.C.T.); and Department of Epidemiology and Biostatistics, Dornsife School of Public Health, Drexel University School of Public Health, Philadelphia, PA (A.V.D.R.).
authors.forename: Anjum
authors.initials: A
authors.lastname: Hajat
authors.affiliation: From Department of Public Health, Grand Valley State University, Grand Rapids, MI (J.J.W.); Departments of Epidemiology (E.A., S.D.A.) and Biostatistics (B.S.), University of Michigan School of Public Health, Ann Arbor; Departments of Environmental and Occupational Health Sciences (A.L.D.) and Epidemiology (A.H.), University of Washington School of Public Health, Seattle; Department of Medicine, University of Wisconsin School of Medicine and Public Health, Madison (J.H.S., M.C.T.); and Department of Epidemiology and Biostatistics, Dornsife School of Public Health, Drexel University School of Public Health, Philadelphia, PA (A.V.D.R.).
authors.forename: Brisa N
authors.initials: BN
authors.lastname: Sánchez
authors.affiliation: From Department of Public Health, Grand Valley State University, Grand Rapids, MI (J.J.W.); Departments of Epidemiology (E.A., S.D.A.) and Biostatistics (B.S.), University of Michigan School of Public Health, Ann Arbor; Departments of Environmental and Occupational Health Sciences (A.L.D.) and Epidemiology (A.H.), University of Washington School of Public Health, Seattle; Department of Medicine, University of Wisconsin School of Medicine and Public Health, Madison (J.H.S., M.C.T.); and Department of Epidemiology and Biostatistics, Dornsife School of Public Health, Drexel University School of Public Health, Philadelphia, PA (A.V.D.R.).
authors.forename: James H
authors.initials: JH
authors.lastname: Stein
authors.affiliation: From Department of Public Health, Grand Valley State University, Grand Rapids, MI (J.J.W.); Departments of Epidemiology (E.A., S.D.A.) and Biostatistics (B.S.), University of Michigan School of Public Health, Ann Arbor; Departments of Environmental and Occupational Health Sciences (A.L.D.) and Epidemiology (A.H.), University of Washington School of Public Health, Seattle; Department of Medicine, University of Wisconsin School of Medicine and Public Health, Madison (J.H.S., M.C.T.); and Department of Epidemiology and Biostatistics, Dornsife School of Public Health, Drexel University School of Public Health, Philadelphia, PA (A.V.D.R.).
authors.forename: Matthew C
authors.initials: MC
authors.lastname: Tattersall
authors.affiliation: From Department of Public Health, Grand Valley State University, Grand Rapids, MI (J.J.W.); Departments of Epidemiology (E.A., S.D.A.) and Biostatistics (B.S.), University of Michigan School of Public Health, Ann Arbor; Departments of Environmental and Occupational Health Sciences (A.L.D.) and Epidemiology (A.H.), University of Washington School of Public Health, Seattle; Department of Medicine, University of Wisconsin School of Medicine and Public Health, Madison (J.H.S., M.C.T.); and Department of Epidemiology and Biostatistics, Dornsife School of Public Health, Drexel University School of Public Health, Philadelphia, PA (A.V.D.R.).
authors.forename: Ana V
authors.initials: AV
authors.lastname: Diez Roux
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D015331:Cohort Studies; D003324:Coronary Artery Disease / Q000175:diagnosis* / Q000208:ethnology* / Q000517:prevention & control; D000072001:Diet, Healthy / Q000639:trends; D018450:Disease Progression; D005006:Ethnicity; D005260:Female; D005500:Follow-Up Studies; D005523:Food Supply; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D012111:Residence Characteristics; D012307:Risk Factors; D061205:Vascular Calcification / Q000175:diagnosis* / Q000208:ethnology* / Q000517:prevention & control
keywords: atherosclerosis; coronary disease