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October 11, 2022BMC Public HealthOpen Access

Examining relationships between perceived neighborhood social cohesion and ideal cardiovascular health and whether psychosocial stressors modify observed relationships among JHS, MESA, and MASALA participants

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Key result

High perceived neighborhood social cohesion was not significantly associated with ideal or intermediate cardiovascular health compared to low cohesion (aPR 1.01), 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?

Population

6,086 participants across Jackson Heart Study, Multi-Ethnic Study of Atherosclerosis, and MASALA study

Comparison

High or medium vs low perceived neighborhood social cohesion

Design

Longitudinal cohort study

Authors

ADAkilah DulinJPJee Won ParkMSMatthew M. Scarpaci

Discussion

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Member takes

Overview

No clear link between neighborhood cohesion and LS7; leaves open whether cohesion interventions improve CVH in diverse groups.

Study Design

Type

Cohort (n=6,086)

Multicenter

Yes

Structured PICO

Does high perceived neighborhood social cohesion improve cardiovascular health (Life's Simple 7) in diverse US adults?

P
Population
6,086 diverse adults from three US cohorts (JHS, MESA, MASALA) followed longitudinally to assess the relationship between neighborhood social cohesion and cardiovascular health.
E
Exposure
High or medium perceived neighborhood social cohesion (measured in tertiles)
C
Comparator
Low perceived neighborhood social cohesion
O
Outcome
Ideal and intermediate versus poor cardiovascular health (CVH) defined by the composite American Heart Association's Life's Simple 7 (LS7) metricscomposite

Main Result

Relative Risk: 1.01 (95% CI 0.97–1.05)

Perceived neighborhood social cohesion was not significantly associated with ideal cardiovascular health, though psychosocial stressors like education and discrimination modified the relationship.

Limitations

  • The neighborhood social cohesion measure does not fully capture social inclusion and social capital components.
  • Tertiles are sample dependent and may not truly reflect levels in the general population.
  • Census tracts used as proxies for neighborhood environments may not map onto participants' perceptions.
  • Did not account for participants moving to different census tracts after Exam 1.
  • Exclusion of participants with missing data may have resulted in selection bias.
  • Findings may not be generalizable to populations with different distributions of effect modifiers.

Cite This Study

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 significantly associated with ideal or intermediate cardiovascular health compared to low cohesion (aPR 1.01), though psychosocial stressors modified this relationship.

synapsesocial.com/papers/6a7c9d4e1b0fae09726ee425https://doi.org/10.1186/s12889-022-14270-x
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