title: Neighborhood Disadvantage, Poor Social Conditions, and Cardiovascular Disease Incidence Among African American Adults in the Jackson Heart Study.
abstract: OBJECTIVE
  To examine the impact of neighborhood conditions resulting from racial residential segregation on cardiovascular disease (CVD) risk in a socioeconomically diverse African American sample.
  
  
  METHODS
  The study included 4096 African American women (n = 2652) and men (n = 1444) aged 21 to 93 years from the Jackson Heart Study (Jackson, Mississippi; 2000-2011). We assessed neighborhood disadvantage with a composite measure of 8 indicators from the 2000 US Census. We assessed neighborhood-level social conditions, including social cohesion, violence, and disorder, with self-reported, validated scales.
  
  
  RESULTS
  Among African American women, each standard deviation increase in neighborhood disadvantage was associated with a 25% increased risk of CVD after covariate adjustment (hazard ratio = 1.25; 95% confidence interval = 1.05, 1.49). Risk also increased as levels of neighborhood violence and physical disorder increased after covariate adjustment. We observed no statistically significant associations among African American men in adjusted models.
  
  
  CONCLUSIONS
  Worse neighborhood economic and social conditions may contribute to increased risk of CVD among African American women. Policies directly addressing these issues may alleviate the burden of CVD in this group.
authors.affiliation: Sharrelle Barber, Xu Wang, and Ana V. Diez-Roux are with Drexel University School of Public Health, Department of Epidemiology and Biostatistics, and Center for Integrative Approaches to Health Disparities, Philadelphia, PA. DeMarc A. Hickson and Mario Sims are with University of Mississippi Medical Center, Jackson. Cheryl Nelson is with National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, MD.
authors.forename: Sharrelle
authors.initials: S
authors.lastname: Barber
authors.affiliation: Sharrelle Barber, Xu Wang, and Ana V. Diez-Roux are with Drexel University School of Public Health, Department of Epidemiology and Biostatistics, and Center for Integrative Approaches to Health Disparities, Philadelphia, PA. DeMarc A. Hickson and Mario Sims are with University of Mississippi Medical Center, Jackson. Cheryl Nelson is with National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, MD.
authors.forename: DeMarc A
authors.initials: DA
authors.lastname: Hickson
authors.affiliation: Sharrelle Barber, Xu Wang, and Ana V. Diez-Roux are with Drexel University School of Public Health, Department of Epidemiology and Biostatistics, and Center for Integrative Approaches to Health Disparities, Philadelphia, PA. DeMarc A. Hickson and Mario Sims are with University of Mississippi Medical Center, Jackson. Cheryl Nelson is with National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, MD.
authors.forename: Xu
authors.initials: X
authors.lastname: Wang
authors.affiliation: Sharrelle Barber, Xu Wang, and Ana V. Diez-Roux are with Drexel University School of Public Health, Department of Epidemiology and Biostatistics, and Center for Integrative Approaches to Health Disparities, Philadelphia, PA. DeMarc A. Hickson and Mario Sims are with University of Mississippi Medical Center, Jackson. Cheryl Nelson is with National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, MD.
authors.forename: Mario
authors.initials: M
authors.lastname: Sims
authors.affiliation: Sharrelle Barber, Xu Wang, and Ana V. Diez-Roux are with Drexel University School of Public Health, Department of Epidemiology and Biostatistics, and Center for Integrative Approaches to Health Disparities, Philadelphia, PA. DeMarc A. Hickson and Mario Sims are with University of Mississippi Medical Center, Jackson. Cheryl Nelson is with National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, MD.
authors.forename: Cheryl
authors.initials: C
authors.lastname: Nelson
authors.affiliation: Sharrelle Barber, Xu Wang, and Ana V. Diez-Roux are with Drexel University School of Public Health, Department of Epidemiology and Biostatistics, and Center for Integrative Approaches to Health Disparities, Philadelphia, PA. DeMarc A. Hickson and Mario Sims are with University of Mississippi Medical Center, Jackson. Cheryl Nelson is with National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, MD.
authors.forename: Ana V
authors.initials: AV
authors.lastname: Diez-Roux
mesh_terms: D000328:Adult; D001741:Black or African American; D000368:Aged; D000369:Aged, 80 and over; D002318:Cardiovascular Diseases / Q000453:epidemiology*; D015331:Cohort Studies; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D008922:Mississippi / Q000453:epidemiology; D011204:Poverty Areas; D055815:Young Adult