Marcus R Andrews, Dana Sandler, Shirley Lopez De Leon, Seann Regan, Wayne R Lawrence, James F Troendle, Tiffany M Powell-Wiley
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引用次数: 0
Abstract
Background: Epidemiologic studies have linked neighborhood socioeconomic conditions to health. However, few have examined neighborhood structural investment (NSI) influences on cardiometabolic risk markers across urban environments. This study investigated whether NSI varies by historic redlining, associations between NSI and the prevalence of obesity, diabetes, and coronary heart disease (CHD) and whether redlining's effect on obesity, diabetes, and CHD prevalence are mediated by neighborhood structural investment.
Methods: NSI was measured using a composite score based on census tract data from MapUSA, which included home value, rent, vacant houses, and structures older than 30 years (higher scores representing greater investment). Obesity, diabetes, and CHD prevalence estimates were from the 2024 CDC's 500 Cities 2024 data. Redlining data from the Home Owners' Loan Corporation (HOLC) scores from the University of Richmond's Mapping Inequality Project were analyzed for seventeen U.S. cities. NSI was tested as a mediator of these associations. Models were adjusted for % Black, % of people 60 and older, % of families in poverty, % of people with a college degree, % unemployed, median household income, and length of residency.
Results: Living in a formerly redlined neighborhood was associated with lower NSI longitudinally. NSI was associated with decreased obesity, diabetes, and CHD prevalence, but these associations varied by city. NSI mediated associations between redlining and health outcomes varying by city.
Conclusions: This study suggests that historic redlining is associated with contemporary health outcomes via neighborhood structural investment. Such findings could be used to inform cardiometabolic health intervention designs.
期刊介绍:
The American Journal of Preventive Medicine is the official journal of the American College of Preventive Medicine and the Association for Prevention Teaching and Research. It publishes articles in the areas of prevention research, teaching, practice and policy. Original research is published on interventions aimed at the prevention of chronic and acute disease and the promotion of individual and community health.
Of particular emphasis are papers that address the primary and secondary prevention of important clinical, behavioral and public health issues such as injury and violence, infectious disease, women''s health, smoking, sedentary behaviors and physical activity, nutrition, diabetes, obesity, and substance use disorders. Papers also address educational initiatives aimed at improving the ability of health professionals to provide effective clinical prevention and public health services. Papers on health services research pertinent to prevention and public health are also published. The journal also publishes official policy statements from the two co-sponsoring organizations, review articles, media reviews, and editorials. Finally, the journal periodically publishes supplements and special theme issues devoted to areas of current interest to the prevention community.