Abstract WE491: Effect Modification of Walkability and Micro-scale Walkability on the relationship between Socioeconomic Deprivation and Cardiovascular Health Outcomes in the Hispanic Community Health Study/ Study of Latinos (HCHS/SOL): A Longitudinal Analysis

Background: Poor cardiovascular health (CVH) remains a leading cause of morbidity and mortality among US Hispanic/Latino adults, with previous research identifying the important role that social determinants play. We aimed to examine longitudinal associations between neighborhood socioeconomic deprivation, walkability, and pedestrian streetscape with changes in CVH in Hispanic/Latino Adults. Methods: Data were from 1,126 Hispanics/Latinos (ages 24 to 80; 56% female; 93% Mexican origin) enrolled in the San Diego site of Hispanic Community Health Study/Study of Latinos (HCHS/SOL). Neighborhood data were collected at Visit 2 (2014-2017), as part of the SOL CASAS ancillary study, and clinical data were examined at Visits 2&3 (2020-2024). Home addresses were geocoded and home areas created using 800m circular buffers. Neighborhood socioeconomic deprivation was created using Census data. Walkability was computed as land use mix and intersection and residential density. Pedestrian streetscape was measured using virtual street audits near each participant's home address. Using the four-health metrics of the American Heart Association “Life’s Essential 8” (body mass index, non-HDL cholesterol, HbA1c, and blood pressure) we built CVH scores for both timepoints. Our primary outcome was defined as residualized change in CVH score across the 6-years between visits. Complex survey models controlling for individual demographic, socioeconomic, and all independent variables were used to estimate the linear associations. Formal interaction tests and stratification by walkability were used to estimate potential interactions across our three independent variables. Results: Average CVH scores at Visit 2 were 65.8/100 and 63.4/100 at Visit 3. In fully adjusted models, socioeconomic deprivation (β = –1.54, SE = 0.67, p=.02) was negatively associated with change in CVH scores while walkability (β = 1.64, SE = 0.72, p=.03) was positively associated. Only the interaction between walkability and pedestrian streetscape was significant (β = 1.20, SE = 0.56, p=.03), with pedestrian streetscape being significant negatively associated with change in CVH scores in the lowest tertile of walkability (β = -3.31, SE = 1.13, p<.01). Conclusion: Neighborhood socioeconomic deprivation and walkability influence changes in CVH among US Hispanic/Latino adults. Pedestrian streetscape may influence changes in CVH but only in the presence or lack of walkability.