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Background While the impacts of social and environmental exposure on cardiovascular risks are often reported individually, the combined effect is poorly understood. Methods and Results Using the 2022 Environmental Justice Index, socio‐environmental justice index and environmental burden module ranks of census tracts were divided into quartiles (quartile 1, the least vulnerable census tracts; quartile 4, the most vulnerable census tracts). Age‐adjusted rate ratios (RRs) of coronary artery disease, strokes, and various health measures reported in the Prevention Population‐Level Analysis and Community Estimates data were compared between quartiles using multivariable Poisson regression. The quartile 4 Environmental Justice Index was associated with a higher rate of coronary artery disease (RR, 1.684 95% CI, 1.660–1.708) and stroke (RR, 2.112 95% CI, 2.078–2.147) compared with the quartile 1 Environmental Justice Index. Similarly, coronary artery disease 1.057 95% CI,1.043‐1.0716 and stroke (RR, 1.118 95% CI, 1.102–1.135) were significantly higher in the quartile 4 than in the quartile 1 environmental burden module. Similar results were observed for chronic kidney disease, hypertension, diabetes, obesity, high cholesterol, lack of health insurance, sleep 14 days. Conclusions The prevalence of CVD and its risk factors is highly associated with increased social and environmental adversities, and environmental exposure plays an important role independent of social factors.
Khadke et al. (Wed,) studied this question.