Key result
High perceived neighborhood social cohesion was not associated with ideal or intermediate cardiovascular health compared to low cohesion, though psychosocial stressors modified this relationship.
Why the study?
Psychosocial stressors increase CVD risk, but neighborhood-level resilience resources may protect CVH; longitudinal associations between neighborhood social cohesion and Life's Simple 7, plus potential modification by psychosocial stressors, remained to be examined.
Does high perceived neighborhood social cohesion improve cardiovascular health (Life's Simple 7) in diverse US adults?
Cohort (n=6,086)
Yes
Does high perceived neighborhood social cohesion improve cardiovascular health (Life's Simple 7) in diverse US adults?
Perceived neighborhood social cohesion was not significantly associated with ideal cardiovascular health, though psychosocial stressors like education and discrimination modified the relationship.
Answers are grounded in this paper and cite their sources.
No clear link between neighborhood cohesion and LS7; leaves open whether cohesion interventions improve CVH in diverse groups.
BACKGROUND: Psychosocial stressors increase the risks for cardiovascular disease across diverse populations. However, neighborhood level resilience resources may protect against poor cardiovascular health (CVH). This study used data from three CVH cohorts to examine longitudinally the associations of a resilience resource, perceived neighborhood social cohesion (hereafter referred to as neighborhood social cohesion), with the American Heart Association's Life's Simple 7 (LS7), and whether psychosocial stressors modify observed relationships. METHODS: We examined neighborhood social cohesion (measured in tertiles) and LS7 in the Jackson Heart Study, Multi-Ethnic Study of Atherosclerosis, and Mediators of Atherosclerosis in South Asians Living in America study. We used repeated-measures, modified Poisson regression models to estimate the relationship between neighborhood social cohesion and LS7 (primary analysis, n = 6,086) and four biological metrics (body mass index, blood pressure, cholesterol, blood glucose; secondary analysis, n = 7,291). We assessed effect measure modification by each psychosocial stressor (e.g., low educational attainment, discrimination). RESULTS: In primary analyses, adjusted prevalence ratios (aPR) and 95% confidence intervals (CIs) for ideal/intermediate versus poor CVH among high or medium (versus low) neighborhood social cohesion were 1.01 (0.97-1.05) and 1.02 (0.98-1.06), respectively. The psychosocial stressors, low education and discrimination, functioned as effect modifiers. Secondary analyses showed similar findings. Also, in the secondary analyses, there was evidence for effect modification by income. CONCLUSION: We did not find much support for an association between neighborhood social cohesion and LS7, but did find evidence of effect modification. Some of the effect modification results operated in unexpected directions. Future studies should examine neighborhood social cohesion more comprehensively and assess for effect modification by psychosocial stressors.
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Dulin et al. (2022) conducted a cohort in Cardiovascular health (n=6,086). Perceived neighborhood social cohesion vs. Low neighborhood social cohesion was evaluated on Ideal or intermediate versus poor cardiovascular health (Life's Simple 7) (aPR 1.01, 95% CI 0.97-1.05). High perceived neighborhood social cohesion was not associated with ideal or intermediate cardiovascular health compared to low cohesion, though psychosocial stressors modified this relationship.
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