Double-Jeopardy: The Joint Impact of Neighborhood Disadvantage and Low Social Cohesion on Cumulative Risk of Disease Among African American Men and Women in the Jackson Heart Study

Details

• Alternative Title:
  Soc Sci Med
• Personal Author:
  Barber, Sharrelle ; Hickson, DeMarc A. ; Kawachi, Ichiro ; Subramanian, S.V. ; Earls, Felton
• Description:
  Objectives
  
  Few studies have examined the joint impact of neighborhood disadvantage and low social cohesion on health. Moreover, no study has considered the joint impact of these factors on a cumulative disease risk profile among a large sample of African American adults. Using data from the Jackson Heart Study, we examined the extent to which social cohesion modifies the relationship between neighborhood disadvantage and cumulative biological risk (CBR)—a measure of accumulated risk across multiple physiological systems.
  
  Methods
  
  Our analysis included 4,408 African American women and men ages 21–85 residing in the Jackson, MS Metropolitan Area. We measured neighborhood disadvantage using a composite score of socioeconomic indicators from the 2000 US Census and social cohesion was assessed using a 5-item validated scale. Standardized z-scores of biomarkers representing cardiovascular, metabolic, inflammatory, and neuroendocrine systems were combined to create a CBR score. We used two-level linear regression models with random intercepts adjusting for socio-demographic and behavioral covariates in the analysis. A three-way interaction term was included to examine whether the relationship between neighborhood disadvantage and CBR differed by levels of social cohesion and gender.
  
  Results
  
  The interaction between neighborhood disadvantage, social cohesion and gender was statistically significant (p=0.05) such that the association between living in a disadvantaged neighborhood and CBR was strongest for men living in neighborhoods with low levels of social cohesion (B=0.63, SE: 0.32). In gender-specific models, we found a statistically significant interaction between neighborhood disadvantage and social cohesion for men (p=0.05) but not for women (p=0.50).
  
  Conclusion
  
  Neighborhoods characterized by high levels of economic disadvantage and low levels of social cohesion contribute to higher cumulative risk of disease among African American men. This suggests that they may face a unique set of challenges that put them at greater risk in these settings.
  
  
• Subjects:
  Adult Aged Aged, 80 And Over Black Or African American Female Health Status Disparities Heart Diseases Humans Interpersonal Relations Male Middle Aged Poverty Areas Residence Characteristics Risk Factors Sex Distribution Young Adult

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• Source:
  Soc Sci Med. 153:107-115
• Pubmed ID:
  26894941
• Pubmed Central ID:
  PMC4788553
• Document Type:
  Journal Article
• Funding:
  P20 GM103476/GM/NIGMS NIH HHS/United States ; R01 HL071759/HL/NHLBI NIH HHS/United States ; HHSN268201300049C/PHS HHS/United States ; T32 HL 098048-02/HL/NHLBI NIH HHS/United States ; HHSN268201300048C/PHS HHS/United States ; R25 MH083620/MH/NIMH NIH HHS/United States ; P60 MD002249/MD/NIMHD NIH HHS/United States ; HHSN268201300047C/PHS HHS/United States ; U01 PS003315/PS/NCHHSTP CDC HHS/United States ; 5 R25 GM 055353/GM/NIGMS NIH HHS/United States ; HHSN268201300048C/HL/NHLBI NIH HHS/United States ; P60MD002249 05S1/MD/NIMHD NIH HHS/United States ; HHSN268201300049C/HL/NHLBI NIH HHS/United States ; HHSN268201300050C/PHS HHS/United States ; HHSN268201300046C/PHS HHS/United States ; HHSN268201300047C/HL/NHLBI NIH HHS/United States ; HHSN268201300050C/HL/NHLBI NIH HHS/United States ; T32 HL098048/HL/NHLBI NIH HHS/United States ; HHSN268201300046C/HL/NHLBI NIH HHS/United States ; R25 GM055353/GM/NIGMS NIH HHS/United States
• Place as Subject:
  Mississippi
• Volume:
  153
• Collection(s):
  CDC Public Access
• Main Document Checksum:
  urn:sha256:7d5545cf0836e9e87dfee9648e4415f5103cffc6842edfb052be33ba58af5d35
• Download URL:
  https://stacks.cdc.gov/view/cdc/40157/cdc_40157_DS1.pdf
• File Type:
  [PDF - 422.32 KB ]