Black people who live in neighborhoods that are segregated from other racial/ethnic groups are more likely to develop cardiovascular disease (CVD), compared to those living in more integrated neighborhoods, according to a recent Northwestern Medicine study published in Circulation.
“This finding held true even after adjusting for measures of neighborhood characteristics, social environment and various individual factors,” said first author Kiarri Kershaw, PhD, MPH, ’12 GME, assistant professor in Preventive Medicine-Epidemiology.
The opposite was true white people who reside in predominantly white neighborhoods: They had a lower CVD risk than their counterparts, a finding Kershaw said was largely explained by differences in neighborhood poverty. There was no association in either direction for people of Hispanic descent.
“Our results suggest the processes that lead to segregation vary across racial and ethnic groups,” Kershaw said. “As such, so do the consequences of segregation on health.”
The study’s investigators used data from the Multi-Ethnic Study of Atherosclerosis (MESA), prospectively examining CVD in adults aged 45 to 84 that were recruited from six sites across the United States, including Chicago. The study included 1,595 black participants, 2,345 white participants and 1,289 Hispanic participants. None had CVD at baseline.
Follow-up about 10 years after recruitment revealed that every increase in neighborhood segregation measurement was associated with a 12 percent higher risk of developing CVD among black participants.
Though exclusionary housing practices have been outlawed in the United States for more than 50 years, the authors point out in the paper, residential segregation remains widespread.
“A better understanding of what it is about living in a segregated neighborhood that influences health, such as access to healthy foods or exposure to violence, will help policymakers decide the best approach for addressing segregation in major cities like Chicago,” Kershaw said.
Though many studies have examined the links between race/ethnicity and health outcomes, this is the first to comprehensively focus on CVD and neighborhood segregation.
“Previous studies in this area have used death certificate data and have not been able to adjust for neighborhood characteristics or detailed individual factors,” Kershaw said. “Our study was able to examine outcomes in participants with more detailed data available and account for changes in residence that occurred while participants were in the study.”
This study was supported by the National Institutes of Health (NIH) National Heart, Lung, and Blood Institute grant R01 HL071759 and contracts N01-HC-95159 through N01-HC-95169 and NIH National Center for Research Resources grants UL1-RR-024156 and UL1-RR-025005.
