Key result
Disadvantaged neighborhood residence is linked to worse heart failure self-care maintenance after recent readmission.
Why the study?
The association between the degree of neighborhood socioeconomic disadvantage and heart failure self-care adherence was unclear.
Does residence in a highly disadvantaged neighborhood predict poor heart failure self-care adherence in adults with heart failure?
Cross-Sectional (n=82)
Yes
Does residence in a highly disadvantaged neighborhood predict poor heart failure self-care adherence in adults with heart failure?
Effect estimate: β = -0.344
p-value: p=0.002
Neighborhood disadvantage, rather than individual sociodemographic characteristics, is a significant predictor of poor heart failure self-care adherence.
Disadvantaged neighborhoods may flag higher risk for poor HF self-care; this Level 5 analysis leaves open causal mechanisms and intervention effects.
Background: Residence in socioeconomically disadvantaged neighborhoods contributes to worse heart failure outcomes and may influence patient’s heart failure self-care adherence. However, the association between the degree of neighborhood disadvantage and heart failure self-care is unclear. Objective: The purpose of this secondary analysis was to investigate whether neighborhood disadvantage predicted HF self-care adherence.Methods: This study was a secondary analysis of baseline data from a mixed-method study of 82 adults with heart failure. Participant zip codes were assigned a degree of neighborhood disadvantage using the Area Deprivation Index (ADI). Those in the top 20% most disadvantaged neighborhoods (ADI > 80) were compared to those in the least disadvantaged neighborhoods (ADI < 80). The self-care of heart failure index was used to measure self-care maintenance and monitoring. Simple linear regression examined whether neighborhood disadvantage predicted HF self-care adherence. Results: Of all participants, 59.8% were male, 59.8% were persons of color and the mean age was 64.87 years. Residing in a highly disadvantaged neighborhood predicted poor adherence to HF self-care maintenance and monitoring. While persons of color were more likely to reside in neighborhoods with high disadvantage, individual sociodemographic characteristics were not associated with HF self-care. Conclusion: Residing in a disadvantaged neighborhood may be an important risk factor for heart failure self-care nonadherence. Differences in heart failure self-care adherence cannot be attributed solely to the individual-level social determinants of race, annual household, marital status, or level of education. More research is needed to understand the connection between neighborhood disadvantage and heart failure self-care.
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Meraz et al. (2023) conducted a cross-sectional in Heart failure (n=82). Neighborhood disadvantage (Area Deprivation Index > 80) vs. Least disadvantaged neighborhoods (ADI < 80) was evaluated on Heart Failure Self-Care Maintenance (β = -0.344, p=0.002). Residing in a highly disadvantaged neighborhood significantly predicted worse heart failure self-care maintenance (β = -0.344, p = 0.002) among patients with a recent 90-day readmission.
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