WEDNESDAY, July 11, 2001 (HealthDayNews) -- Your risk of heart disease may be affected by the neighborhood where you live, a study finds.
Using a six-item scale to measure neighborhood environment, researchers find that "living in the most disadvantaged group of neighborhoods, as compared with the most advantaged group, was associated with a 70 to 90 percent higher risk of coronary disease in whites and a 30 to 50 percent higher risk in blacks," says a report in the July 12 New England Journal of Medicine.
The reasons for the difference are unclear, says study leader Dr. Ana V. Diez Roux, assistant professor of medicine and public health at the Columbia College of Physicians and Surgeons in New York City. She says the findings clearly show that the image of heart disease as a menace primarily to hard-driving, upper-class executives is sadly out of date.
"That was probably true in the 1950s, when coronary heart disease was more common in the higher socioeconomic groups," Diez Roux says. "Since then, a major shift has occurred in the United States. There is a very strong, very striking association between lower income, lower education and heart disease risk."
While the socioeconomic shift in heart disease risk has been well documented in the medical literature, "only recently has there been interest in whether the places where people live have an independent effect," she says.
Her study looked at more than 13,000 people living in neighborhoods in Minneapolis, Forsyth County, N.C., Jackson, Miss., and Washington County, Md. Each neighborhood was divided into 1,000-person "block groups," which were classified based on factors such as household income, the value of housing units, years of education and type of employment of residents.
"Even after controlling for personal income, education and occupation, we found that living in a disadvantaged neighborhood is associated with an increased incidence of coronary heart disease," the journal report says.
Though not designed to look at specific neighborhood characteristics that could influence risk, the study indicates several possibilities, Diez Roux says.
"There are things that might affect exercise, such as the absence of public parks where people feel safe while exercising," she says. "It could be the availability and cost of different types of food. It also could be advertising, exposure to cigarette ads."
A new study to identify "what specific things are responsible, and how they affect people" is in the early planning stage, says Diez Roux.
Other studies looking at overall health and mortality are under way, says Dr. George Kaplan, professor and chairman of the department of epidemiology at the University of Michigan.
Diez Roux's study is one of many that "have established the important relationship between the relative characteristics of the area in which people live and their chances of a healthy, functional life," Kaplan says. He reported a study showing that residents of poverty areas in northern California had a 50 percent increased risk of death over a nine-year period.
Kaplan and his colleagues now are conducting a study in 343 areas in Chicago to look at "all the behavioral and psychosocial factors that might link neighborhoods and health."
"We hope to get a better sense of the relationships," he says.
What To Do No matter what neighborhood you live in, risk factors such as diet, smoking and exercise are important.
For a rundown on disparities in health risks, go to the National Heart, Lung and Blood Institute. The American Heart Association has more information on risk awareness.
