Historical redlining and cardiovascular health: The Multi-Ethnic Study of Atherosclerosis

We investigated historical redlining, a government-sanctioned discriminatory policy, in relation to cardiovascular health (CVH) and whether associations were modified by present-day neighborhood physical and social environments. Data included 4,779 participants (mean age 62 y; SD = 10) from the baseline sample of the Multi-Ethnic Study of Atherosclerosis (MESA; 2000 to 2002). Ideal CVH was a summary measure of ideal levels of seven CVH risk factors based on established criteria (blood pressure, fasting glucose, cholesterol, body mass index, diet, physical activity, and smoking). We assigned MESA participants’ neighborhoods to one of four grades (A: best, B: still desirable, C: declining, and D: hazardous) using the 1930s federal Home Owners’ Loan Corporation (HOLC) maps, which guided decisions regarding mortgage financing. Two-level hierarchical linear and logistic models, with a random intercept to account for participants nested within neighborhoods (i.e., census tracts) were used to assess associations within racial/ethnic subgroups (non-Hispanic White, non-Hispanic Black, Hispanic, and non-Hispanic Chinese). We found that Black adults who lived in historically redlined areas had a 0.82 (95% CI −1.54, −0.10) lower CVH score compared to those residing in grade A (best) neighborhoods, in a given neighborhood and adjusting for confounders. We also found that as the current neighborhood social environment improved the association between HOLC score and ideal CVH weakened (P < 0.10). There were no associations between HOLC grade and CVH measures or effect modification by current neighborhood conditions for any other racial/ethnic group. Results suggest that historical redlining has an enduring impact on cardiovascular risk among Black adults in the United States.

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Longitudinal Associations between the Neighborhood Built Environment and Cognition in US Older Adults: The Multi-Ethnic Study of Atherosclerosis

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph18157973 ◽

2021 ◽

Vol 18 (15) ◽

pp. 7973

Author(s):

Lilah M. Besser ◽

Lun-Ching Chang ◽

Jana A. Hirsch ◽

Daniel A. Rodriguez ◽

John Renne ◽

...

Keyword(s):

Processing Speed ◽

Cognitive Abilities ◽

Logistic Models ◽

Ethnically Diverse ◽

Cognitive Measures ◽

Ethnic Study ◽

Random Intercept ◽

Global Cognition ◽

Cognitive Measurement ◽

Neighborhood Built Environment

Few studies have examined associations between neighborhood built environments (BE) and longitudinally measured cognition. We examined whether four BE characteristics were associated with six-year change in global cognition and processing speed. We obtained data on 1816 participants without dementia from the Multi-Ethnic Study of Atherosclerosis. BE measures included social destination density, walking destination density, proportion of land dedicated to retail, and network ratio (street connectivity). Global cognition was measured with the Cognitive Abilities Screening Instrument (CASI) and processing speed with the Digit Symbol Coding test (DSC). Multivariable random intercept logistic models tested associations between neighborhood BE at 2010–2012 and maintained/improved cognition (versus decline) from 2010–2018, and mediation by minutes of physical activity (PA)/week. The sample was an average of 67 years old (standard deviation = 8.2) (first cognitive measurement) and racially/ethnically diverse (29% African American, 11% Chinese, 17% Hispanic, 44% White). Compared to individuals with no walking destinations in the 1-mile surrounding their residence, those with 716 walking destinations (maximum observed) were 1.24 times more likely to have maintain/improved DSC score (Odds ratio: 1.24; 95% confidence interval: 1.03–1.45). No other associations were observed between BE and cognition, and PA minutes/week did not mediate the association between walking destination density and DSC change. This study provides limited evidence for an association between greater neighborhood walking destinations and maintained/improved processing speed in older age and no evidence for associations between the other BE characteristics and cognition. Future studies with finer grained BE and cognitive measures and longer-term follow up may be required.

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Racial and Ethnic Differences in Risk and Protective Factors of Dementia and CIND in the United States

Innovation in Aging ◽

10.1093/geroni/igaa057.2304 ◽

2020 ◽

Vol 4 (Supplement_1) ◽

pp. 666-666

Author(s):

Nasim Ferdows ◽

Maria Aranda

Keyword(s):

Protective Factors ◽

Ethnic Differences ◽

Cardiovascular Health ◽

Ethnic Disparities ◽

Risk And Protective Factors ◽

The United States ◽

Older Individuals ◽

Assessment Protocol ◽

Dementia Prevalence ◽

Racial Ethnic

Abstract Recent population-based studies have shown declines in dementia prevalence in high-income countries, suggesting that improved population cardiovascular health and rising levels of education in the past 25 year were associated with reduction of dementia risks. However, in the US, there are variations in educational attainment, prevalence and management of chronic diseases, and behaviors associated with poor cardiovascular health among racial and ethnic groups. We performed a retrospective analysis of 3,495 older individuals (65+) in 2016 who participated in Harmonized Cognitive Assessment Protocol (HCAP) subsample of the Health and Retirement Study (HRS), to examine racial/ethnic differences in risk and protective factors associated with dementia and cognitive impairment. Linking HCAP to HRS, we traced individuals back to 2000 and created a longitudinal data of HCAP population (2000-2016). We found that racial/ethnic differences in risk and in protective factors throughout the life-course were associated with racial and ethnic disparities in dementia prevalence.

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Differences in Diet Quality among Multiple US Racial/Ethnic Groups from the Mediators of Atherosclerosis in South Asians Living in America (MASALA) Study and the Multi-Ethnic Study of Atherosclerosis (MESA)

Journal of Nutrition ◽

10.1093/jn/nxaa050 ◽

2020 ◽

Vol 150 (6) ◽

pp. 1509-1515 ◽

Cited By ~ 1

Author(s):

Luis A Rodriguez ◽

Yichen Jin ◽

Sameera A Talegawkar ◽

Marcia C de Oliveira Otto ◽

Namratha R Kandula ◽

...

Keyword(s):

United States ◽

African Americans ◽

Ethnic Groups ◽

South Asian ◽

Diet Quality ◽

South Asians ◽

Chinese Americans ◽

The United States ◽

Ethnic Study ◽

Racial Ethnic

ABSTRACT Background Diet quality is an important risk factor for type 2 diabetes (T2D) and cardiovascular disease (CVD). Little is known about the diet quality of South Asians in the United States, a group with higher rates of T2D and CVD compared with other racial/ethnic groups. Objective This study determined whether diet quality differs between South Asian adults in the Mediators of Atherosclerosis in South Asians Living in America (MASALA) Study and whites, Chinese Americans, African Americans, and Hispanics in the Multi-Ethnic Study of Atherosclerosis (MESA). Methods Cross-sectional data from 3926 participants free of CVD from MESA visit 5 (2010–2011) and 889 South Asian participants from MASALA visit 1 (2010–2013) were pooled. Diet quality was assessed using the Alternative Healthy Eating Index (AHEI-2010) derived using FFQs. Multivariable linear regression models adjusted for age, sex, and total energy intake were used to compare mean differences in diet quality between the racial/ethnic groups. Results MESA participants were, on average, 14 y older than MASALA participants. The adjusted mean (95% CI) scores for the AHEI-2010 were 70.2 (69.5, 70.9) among South Asians, 66.2 (66.3, 68.2) among Chinese Americans, 61.1 (60.7, 61.6) among whites, 59.0 (58.4, 59.7) among Hispanics, and 57.5 (56.9, 58.1) among African Americans. The mean AHEI scores among South Asians were 3.1 (1.8, 4.3), 9.2 (8.3, 10.1), 11.2 (10.2, 12.3), and 12.8 (11.8, 13.7) points higher compared with Chinese Americans, whites, Hispanics, and African Americans, respectively. Conclusions South Asian adults in the United States have a higher diet quality compared with other racial/ethnic groups. This paradoxical finding is not consistent with the observed higher rates of T2D and CVD compared with other groups. This is further evidence of the importance of studying the South Asian population to better understand the causes of chronic disease not explained by diet quality.

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Abstract P235: Racial/ethnic and Geographic Disparities in Cardiovascular Health Among Pregnant Women in The United States

Circulation ◽

10.1161/circ.141.suppl_1.p235 ◽

2020 ◽

Vol 141 (Suppl_1) ◽

Author(s):

Yi Zheng ◽

Jiang Bian ◽

Heather Lipkind ◽

Jinying Zhao ◽

Thomas A Pearson ◽

...

Keyword(s):

Pregnant Women ◽

Cardiovascular Health ◽

Ethnic Disparities ◽

The United States ◽

Temporal Variations ◽

Self Report ◽

Behavioral Risk ◽

Geographic Disparities ◽

Racial Ethnic ◽

In Pregnancy

Life’s Simple 7 (LS7) developed by the American Heart Association (AHA) reframes cardiovascular disease (CVD) into terms of cardiovascular health (CVH). Large disparities in CVH exist in the general population. However, little is known about the CVH status and its disparities among pregnant women. We used data from two nationally representative surveys to assess racial/ethnic and geographic disparities in pregnancy CVH. Racial/ethnic disparities were examined using data from the 1999-2016 National Health and Nutrition Examination Survey (NHANES). Following LS7, each CVH metric was categorized into poor, intermediate, or ideal. Women with ≥ 4 ideal metrics were determined as having ideal pregnancy CVH. Data from the 2001-2017 Behavioral Risk Factor Surveillance System (BRFSS) were used to identify geographic disparities in pregnancy CVH as determined by self-report and categorized into poor or ideal. Women with > 3 poor metrics were considered as having poor pregnancy CVH. Among the 1,310 pregnant women identified from the NHANES, a lower ideal CVH rate was observed among non-Hispanic Blacks (27.6%), while there were small differences among other racial/ethnic groups (non-Hispanic Whites: 40.5%, Hispanics: 39.7%, and others: 34.7%). Comparing with Non-Hispanic Whites, non-Hispanic Blacks had significantly lower odds to meet an ideal CVH (OR: 0.55, 95% CI: 0.31, 0.97) after adjusting for sociodemographic status. A total of 19,259 pregnant women were identified from the BRFSS. Large geographic disparities in poor pregnancy CVH at the state-level were observed with substantial temporal variations, ranging from 11.7% (Vermont, 2001-2006) to 49.8% (Arkansas, 2013-2017). Continuously increasing rates of poor pregnancy CVH were found in 22 states, while only 2 states (i.e. Kentucky and Washington DC) had continuously decreasing rates in 2001-2017. More efforts are warranted to understand and address these large and increasing disparities in pregnancy CVH.

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Neighborhoods and racial/ethnic differences in ideal cardiovascular health (the Multi-Ethnic Study of Atherosclerosis)

Health & Place ◽

10.1016/j.healthplace.2017.01.005 ◽

2017 ◽

Vol 44 ◽

pp. 61-69 ◽

Cited By ~ 26

Author(s):

Mahasin S. Mujahid ◽

Latetia V. Moore ◽

Lucia C. Petito ◽

Kiarri N. Kershaw ◽

Karol Watson ◽

...

Keyword(s):

Ethnic Differences ◽

Cardiovascular Health ◽

Ethnic Study ◽

Ideal Cardiovascular Health ◽

Racial Ethnic

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Marked Disparities in Pre-Pregnancy Obesity and Overweight Prevalence among US Women by Race/Ethnicity, Nativity/Immigrant Status, and Sociodemographic Characteristics, 2012–2014

Journal of Obesity ◽

10.1155/2019/2419263 ◽

2019 ◽

Vol 2019 ◽

pp. 1-13 ◽

Cited By ~ 9

Author(s):

Gopal K. Singh ◽

Jessica N. DiBari

Keyword(s):

American Indians ◽

Severe Obesity ◽

Chinese Women ◽

Ethnic Disparities ◽

The United States ◽

Social Environments ◽

Childbearing Age ◽

Vietnamese Women ◽

Obesity And Overweight ◽

Racial Ethnic

This study examines racial/ethnic, nativity, and sociodemographic disparities in the prevalence of pre-pregnancy obesity and overweight in the United States. Logistic regression was fitted to the 2012–2014 national birth cohort data to derive unadjusted and adjusted differentials in pre-pregnancy obesity (BMI ≥30), severe obesity (BMI ≥40), and overweight/obesity (BMI ≥25) prevalence among 10.4 million US women of childbearing age. Substantial racial/ethnic differences existed, with pre-pregnancy obesity rates ranging from 2.6% for Chinese and 3.3% for Vietnamese women to 34.9% for American Indians/Alaska Natives (AIANs) and 60.2% for Samoans. Pre-pregnancy overweight/obese prevalence ranged from 13.6% for Chinese women to 61.7% for AIANs and 86.3% for Samoans. Compared to non-Hispanic whites, women in all Asian subgroups had markedly lower risks of pre-pregnancy obesity, severe obesity, and overweight/obesity, whereas Samoans, Hawaiians, AIANs, blacks, Mexicans, Puerto Ricans, and Central/South Americans had significantly higher risks. Immigrant women in each racial/ethnic group had lower rates of pre-pregnancy obesity than the US-born. Sociodemographic risk factors accounted for 33–47% of racial/ethnic disparities and 12–16% of ethnic-immigrant disparities in pre-pregnancy obesity and overweight/obesity. Further research is needed to assess the effects of diet, physical inactivity, and social environments in explaining the reported ethnic and nativity differences in pre-pregnancy obesity.

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Trends in Racial/Ethnic and Nativity Disparities in Cardiovascular Health Among Adults Without Prevalent Cardiovascular Disease in the United States, 1988 to 2014

Annals of Internal Medicine ◽

10.7326/m17-0996 ◽

2018 ◽

Vol 168 (8) ◽

pp. 541 ◽

Cited By ~ 27

Author(s):

Arleen F. Brown ◽

Li-Jung Liang ◽

Stefanie D. Vassar ◽

Jose J. Escarce ◽

Sharon Stein Merkin ◽

...

Keyword(s):

United States ◽

Cardiovascular Disease ◽

Cardiovascular Health ◽

The United States ◽

Racial Ethnic

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Racial, Ethnic, and Geographic Disparities in Cardiovascular Health Among Women of Childbearing Age in the United States

Journal of the American Heart Association ◽

10.1161/jaha.120.020138 ◽

2021 ◽

Author(s):

Yi Zheng ◽

Xiaoxiao Wen ◽

Jiang Bian ◽

Jinying Zhao ◽

Heather S. Lipkind ◽

...

Keyword(s):

Physical Activity ◽

United States ◽

Blood Pressure ◽

Cardiovascular Health ◽

The United States ◽

Women Of Childbearing Age ◽

Childbearing Age ◽

Geographic Disparities ◽

Racial Ethnic ◽

Hispanic White

Background In the United States, large disparities in cardiovascular health (CVH) exist in the general population, but little is known about the CVH status and its disparities among women of childbearing age (ie, 18–49 years). Methods and Results In this cross‐sectional study, we examined racial, ethnic, and geographic disparities in CVH among all women of childbearing age in the United States, using the 2011 to 2019 Behavioral Risk Factor Surveillance System. Life's Simple 7 (ie, blood pressure, glucose, total cholesterol, smoking, body mass index, physical activity, and diet) was used to examine CVH. Women with 7 ideal CVH metrics were determined to have ideal CVH. Among the 269 564 women of childbearing age, 13 800 (4.84%) had ideal CVH. After adjusting for potential confounders, non‐Hispanic Black women were less likely to have ideal CVH (odds ratio, 0.54; 95% CI, 0.46–0.63) compared with non‐Hispanic White women, and with significantly lower odds of having ideal metrics of blood pressure, blood glucose, body mass index, and physical activity. No significant difference in CVH was found between non‐Hispanic White and Hispanic women. Large geographic disparities with temporal variations were observed, with the age‐ and race‐adjusted ideal CVH prevalence ranging from 4.05% in the District of Columbia (2011) to 5.55% in Maine and Montana (2019). States with low ideal CVH prevalence and average CVH score were mostly clustered in the southern United States. Conclusions Large racial, ethnic, and geographic disparities in CVH exist among women of childbearing age. More efforts are warranted to understand and address these disparities.

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1488-P: Closing the Racial/Ethnic Disparity Gap in Kidney Failure from Diabetes in the United States, 2000-2016

Diabetes ◽

10.2337/db20-1488-p ◽

2020 ◽

Vol 69 (Supplement 1) ◽

pp. 1488-P

Author(s):

NILKA RIOS BURROWS ◽

YAN ZHANG ◽

ISRAEL A. HORA ◽

MEDA E. PAVKOV ◽

GIUSEPPINA IMPERATORE

Keyword(s):

United States ◽

Kidney Failure ◽

The United States ◽

Ethnic Disparity ◽

Racial Ethnic

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The Politics of US Latino Literature and American Realism

The Oxford Handbook of American Literary Realism ◽

10.1093/oxfordhb/9780190642891.013.14 ◽

2019 ◽

pp. 231-248

Author(s):

Ramón J. Guerra

Keyword(s):

United States ◽

Social Justice ◽

Mexican Revolution ◽

The United States ◽

Spanish American ◽

Spanish American War ◽

Men And Women ◽

Latino Literature ◽

The Common ◽

Racial Ethnic

This chapter examines the development of Latino literature in the United States during the time when realism emerged as a dominant aesthetic representation. Beginning with the Treaty of Guadalupe Hidalgo (1848) and including the migrations resulting from the Spanish-American War (1898) and the Mexican Revolution (1910), Latinos in the United States began to realistically craft an identity served by a sense of displacement. Latinos living in the United States as a result of migration or exile were concerned with similar issues, including but not limited to their predominant status as working-class, loss of homeland and culture, social justice, and racial/ethnic profiling or discrimination. The literature produced during the latter part of the nineteenth century by some Latinos began to merge the influence of romantic style with a more socially conscious manner to reproduce the lives of ordinary men and women, draw out the specifics of their existence, characterize their dialects, and connect larger issues to the concerns of the common man, among other realist techniques.

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