The Associations of Multiple Dimensions of Discrimination and Abdominal Fat in African American Adults: The Jackson Heart Study

Introduction: Racial residential segregation results in increased exposure to adverse neighborhood environments for African Americans; however, the impact of segregation on ideal cardiovascular health (CVH) has not been examined in large, socioeconomically diverse African American samples. Using a novel spatial measure of neighborhood-level racial residential segregation, we examined the association between segregation and ideal CVH in the Jackson Heart Study (JHS). Hypothesis: Racial residential segregation will be associated with worse cardiovascular health among African American adults. Methods: The sample included 4,354 men and women ages 21-93 from the baseline exam of the JHS (2000-2004). Racial residential segregation was assessed at the census-tract level. Data on racial composition (% African American) from the 2000 US Census was used to calculate the local G i * statistic- a spatially-weighted z-score that represents how much a neighborhood’s racial/ethnic composition deviates from the larger metropolitan area. Ideal CVH was assessed using the AHA Life’s Simple Seven (LS7) index which includes 3 behavioral (nutrition, physical activity, and smoking) and 4 biological (systolic BP, glucose, BMI, and cholesterol) metrics of CVH. Multivariable regression models were used to test associations between segregation and the LS7 index continuously (range: 0-14) and categorically (Inadequate: 0-4; Average: 5-9; and Optimal: 10-14). Covariates included age, sex, income, education, and insurance status. Results: The average LS7 summary score was 7.03 (±2.1) and was lowest in the most racially segregated neighborhood environments (High Segregation: 6.88 ±2.1 vs. Low Segregation: 7.55 ±2.1). The prevalence of inadequate CVH was higher in racially segregated neighborhoods (12.3%) compared to neighborhoods that were the least segregated (6.9%). After adjusting for key socio-demographic characteristics, racial residential segregation was inversely associated with ideal CVH (B=-0.041 ±0.02, p=0.0146). Moreover, a 1-SD unit increase in segregation was associated with a 6% increased odds of having inadequate CVH (OR: 1.06, 95% CI: 1.00-1.12, p=0.0461). Conclusion: In conclusion, African Americans in racially segregated neighborhoods are less likely to achieve ideal CVH even after accounting for individual-level factors. Policies aimed at restricting housing segregation/discrimination and/or structural interventions designed to improve neighborhood environments may be viable strategies to improving CVH in this at-risk population.

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Neighborhood Disadvantage, Poor Social Conditions, and Cardiovascular Disease Incidence Among African American Adults in the Jackson Heart Study

American Journal of Public Health ◽

10.2105/ajph.2016.303471 ◽

2016 ◽

Vol 106 (12) ◽

pp. 2219-2226 ◽

Cited By ~ 36

Author(s):

Sharrelle Barber ◽

DeMarc A. Hickson ◽

Xu Wang ◽

Mario Sims ◽

Cheryl Nelson ◽

...

Keyword(s):

Cardiovascular Disease ◽

African American ◽

Disease Incidence ◽

Neighborhood Disadvantage ◽

Social Conditions ◽

Jackson Heart Study ◽

African American Adults ◽

Heart Study ◽

Cardiovascular Disease Incidence

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The Epidemiology of Coping in African American Adults in the Jackson Heart Study (JHS)

Journal of Racial and Ethnic Health Disparities ◽

10.1007/s40615-017-0445-y ◽

2017 ◽

Vol 5 (5) ◽

pp. 978-994 ◽

Cited By ~ 6

Author(s):

Allison B. Brenner ◽

Ana V. Diez-Roux ◽

Samson Y. Gebreab ◽

Amy J. Schulz ◽

Mario Sims

Keyword(s):

African American ◽

Jackson Heart Study ◽

African American Adults ◽

Heart Study

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Abstract P095: Prospective Association of Physical Activity and Heart Failure Hospitalizations Among African-American Adults with Normal Ejection Fraction: The Jackson Heart Study

Circulation ◽

10.1161/circ.133.suppl_1.p095 ◽

2016 ◽

Vol 133 (suppl_1) ◽

Author(s):

Patrick Koo ◽

Annie Gjelsvik ◽

Gaurav Choudhary ◽

Wen-Chih Wu ◽

Wei Wang ◽

...

Keyword(s):

Physical Activity ◽

Heart Failure ◽

African American ◽

Ejection Fraction ◽

Activity Level ◽

Normal Ejection Fraction ◽

Jackson Heart Study ◽

African American Adults ◽

Heart Study ◽

Crude Analysis

Introduction: Diastolic dysfunction (DD) with normal ejection fraction is prevalent in the African-American population due to a higher prevalence of associated risk factors. The potential benefit of moderate to vigorous physical activity (MVPA) to prevent heart failure admissions in African-American adults with normal ejection fraction is under-researched. The purpose of this study is to investigate the associations of DD and MVPA with heart failure hospitalizations (HFH). Hypothesis: We hypothesized that MVPA reduces the risk of HFH among African-American adults with normal ejection fraction. Methods: We performed a prospective analysis of 2,427 African-American adults who participated in the Jackson Heart Study and who had 2D echo and physical activity data and normal ejection fraction. MVPA per week is defined as the following: poor health [[Unable to Display Character: –]] 0 minutes; intermediate health [[Unable to Display Character: –]] 1-149 minutes; and ideal health [[Unable to Display Character: –]] ≥ 150 minutes. DD is defined as using ratio of the early to late ventricular filling velocities, ratio of pulmonary venous systolic to diastolic velocities, and pulmonary venous atrial reversal velocity. We employed multiple variable logistic and cox proportional regression analyses adjusted for age, gender, BMI, smoking, hypertension, DM, COPD, CKD, and CHD to determine the associations of DD and MVPA with HFH. Results: Of the eligible population, 1,209 (50%) have DD. There were 171 HFH. DD is associated with HFH in the crude analysis (OR=2.24, 95% CI 1.40-3.57). The association was markedly attenuated after adjusting for age (OR=1.03, CI 0.63-1.71). Intermediate and ideal health MVPA in the crude analysis were associated with lower risk of HFH (HR=0.50, 95% CI 0.35-0.71 and HR=0.18, 95% CI 0.09-0.36, respectively), and full models revealed HR=0.71, 95% CI 0.49-1.04 and HR=0.31, 95% CI 0.16-0.63, respectively. There was no interaction between physical activity level and DD on HFH. Conclusion: In conclusion, ideal health MVPA is associated with reduced risk of HFH, whereas, intermediate health MVPA revealed a trend in risk reduction in African-American with normal ejection fraction.

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