scholarly journals Neighbourhood racial/ethnic residential segregation and cardiometabolic risk: the multiethnic study of atherosclerosis

2018 ◽  
Vol 73 (1) ◽  
pp. 26-33 ◽  
Author(s):  
Stephanie L Mayne ◽  
Margaret T Hicken ◽  
Sharon Stein Merkin ◽  
Teresa E Seeman ◽  
Kiarri N Kershaw ◽  
...  
Keyword(s):  
Residential Segregation ◽  
Cardiometabolic Risk ◽  
Medication Use ◽  
Mean Difference ◽  
Cross Sectional ◽  
Racial Residential Segregation ◽  
Individual Level ◽  
Neighbourhood Level ◽  
Ethnic Residential Segregation ◽  
Race Ethnicity

BackgroundRacial residential segregation has been linked to adverse health outcomes, but associations may operate through multiple pathways. Prior studies have not examined associations of neighbourhood-level racial segregation with an index of cardiometabolic risk (CMR) and whether associations differ by race/ethnicity.MethodsWe used data from the Multi-Ethnic Study of Atherosclerosis to estimate cross-sectional and longitudinal associations of baseline neighbourhood-level racial residential segregation with a composite measure of CMR. Participants included 5015 non-Hispanic black, non-Hispanic white and Hispanic participants aged 45–84 years old over 12 years of follow-up (2000–2012). We used linear mixed effects models to estimate race-stratified associations of own-group segregation with CMR at baseline and with the rate of annual change in CMR. Models were adjusted for sociodemographics, medication use and individual-level and neighbourhood-level socioeconomic status (SES).ResultsIn models adjusted for sociodemographics and medication use, high baseline segregation was associated with higher baseline CMR among blacks and Hispanics but lower baseline CMR among whites. Individual and neighbourhood-level SES fully explained observed associations between segregation and CMR for whites and Hispanics. However, associations of segregation with CMR among blacks remained (high vs low segregation: mean difference 0.17 SD units, 95% CI 0.02 to 0.32; medium vs low segregation: mean difference 0.18 SD units, 95% CI 0.03 to 0.33). Baseline segregation was not associated with change in CMR index scores over time.ConclusionAssociations of own-group racial residential segregation with CMR varied by race/ethnicity. After accounting for SES, living in a more segregated neighbourhood was associated with greater risk among black participants only.

Disparities in food consumption between economically segregated urban neighbourhoods

2019 ◽  
Vol 23 (3) ◽  
pp. 525-537 ◽  
Author(s):  
Mariana Souza Lopes ◽  
Waleska Teixeira Caiaffa ◽  
Amanda Cristina de Souza Andrade ◽  
Deborah Carvalho Malta ◽  
Sharrelle Barber ◽  
...  
Keyword(s):  
Residential Segregation ◽  
Care Service ◽  
Binary Logistic Regression ◽  
Cross Sectional ◽  
Individual Level ◽  
Unhealthy Eating ◽  
Urban Neighbourhoods ◽  
Regular Consumption ◽  
Heads Of Household ◽  
Belo Horizonte

AbstractObjective:To examine associations between economic residential segregation and prevalence of healthy and unhealthy eating markers.Design:Cross-sectional. A stratified sample was selected in a three-stage process. Prevalence of eating markers and their 95 % CI were estimated according to economic residential segregation: high (most segregated); medium (integrated) and low (less segregated or integrated). Segregation was measured at the census tract and assessed using the Getis–Ord local $G_i^{\rm{\ast}}$ statistic based on the proportion of heads of household in a neighbourhood earning a monthly income of 0–3 minimum wages. Binary logistic regression using generalized estimating equations were used to model the associations.Setting:Belo Horizonte, Brazil.Participants:Adults (n 1301) residing in the geographical environment (178 census tracts) of ten units of the Brazilian primary-care service known as the Health Academy Program.Results:Of the 1301 participants, 27·7 % lived in highly segregated neighbourhoods, where prevalence of regular consumption of fruit was lower compared with more affluent areas (34·6 v. 53·2 %, respectively). Likewise, regular consumption of vegetables (70·1 v. 87·6 %), fish (23·6 v. 42·3 %) and replacement of lunch or dinner with snacks (0·8 v. 4·7 %) were lower in comparison to more affluent areas. In contrast, regular consumption of beans was higher (91·0 v. 79·5 %). The associations of high-segregated neighbourhood with consumption of vegetables (OR = 0·62; 95 % CI 0·39, 0·98) and beans (OR = 1·85; 95 % CI 1·07, 3·19) remained significant after adjustments.Conclusions:Economic residential segregation was associated with healthy eating markers even after adjustments for individual-level factors and perceived food environment.

Abstract P349: Accelerometer-measured Sleep Duration and Markers of Cardiometabolic Health: Findings From a Large Racially Ethnic Diverse Cohort of Older Adult Women

Circulation ◽  
2018 ◽  
Vol 137 (suppl_1) ◽  
Author(s):  
Kelsie M Full ◽  
Jacqueline Kerr ◽  
Dana Song ◽  
Atul Malhotra ◽  
Linda Gallo ◽  
...  
Keyword(s):  
Sleep Duration ◽  
Older Adult ◽  
Cardiovascular Health ◽  
Cardiometabolic Risk ◽  
Hdl Cholesterol ◽  
Cardiometabolic Health ◽  
Adult Women ◽  
Cross Sectional ◽  
Race Ethnicity ◽  
The Relationship

Background: Cross-sectional and prospective studies have demonstrated that self-reported short sleep is a predictor of cardiometabolic conditions including obesity, Type 2 Diabetes, and cardiovascular events. The relationship may be non-linear, with short and long sleep related to markers of cardiometabolic risk. Research on sleep duration and cardiometabolic health is limited by use of single item self-report sleep measures and homogeneous populations. The current study tested the hypothesis that accelerometer-measured sleep duration would be significantly associated with objective markers of cardiometabolic risk in older adult women. Methods: Cross-sectional data were analyzed in 2662 women (mean age: 79.05, 52.8% white, 29.8% black, 17.4% Hispanic), from the Objective Physical Activity and Cardiovascular Health Study, ancillary study to the Women’s Health Initiative. Women wore accelerometers on the hip for 24 hours over 7 days and completed a daily sleep log. To be included in the present analysis women must have validated night wear for at least 3 nights. Sleep data were scored according to a standard protocol using sleep logs and visual inspection of the accelerometer data. Body mass index (BMI) and fasting blood samples were obtained at home visits prior to accelerometer monitoring. Adjusting for age and race/ethnicity, linear regression models estimated the relationship between sleep duration and BMI (kg/m 2 ), HDL cholesterol, triglycerides, and glucose (mg/dL each), and C-reactive protein (CRP; mg/L). A quadratic term for sleep was included in the models to evaluate nonlinearity. Results: The mean nightly sleep duration in the sample was 489.6 mins per night (8.16 hours) with 14.8% of the sample sleeping less than 7 hours per night and 21% sleeping more than 9 hours per night. After adjusting for age and race/ethnicity, sleep duration was significantly related to BMI (regression coefficient [ B ] :- 0.034, p<.01), and the relationship appeared to be non-linear (quadratic, p=.02). The estimated quadratic function indicated a decreasing BMI as sleep duration increased up to 500 minutes/night, and then an increasing BMI as sleep duration continued to increase beyond 500 minutes/night. Additionally, sleep duration was significantly related to CRP ( B: - 0.005, p=.03), triglycerides ( B: 0.002, p=.03) and glucose ( B: - 0.125, p=.05), with both the CRP (quadratic, p =.02) and glucose (quadratic, p =.03) relationships appearing to be u-shaped and the triglyceride relationship linear. Sleep duration was not significantly related to HDL cholesterol. Conclusions: In older women, there is a significant relationship between sleep duration and cardiometabolic risk factors, independent of age and race/ethnicity. These cross-sectional relationships should be further explored in prospective studies to inform sleep guidelines for better cardiovascular health in older adult women.

scholarly journals Redefining Racial Residential Segregation and its Association With Physical Activity Among African Americans 50 years and Older: A Mixed Methods Approach

2015 ◽  
Vol 23 (2) ◽  
pp. 237-246 ◽  
Author(s):  
Janelle Armstrong-Brown ◽  
Eugenia Eng ◽  
Wizdom Powell Hammond ◽  
Catherine Zimmer ◽  
J. Michael Bowling
Keyword(s):  
Physical Activity ◽  
Mixed Methods ◽  
African Americans ◽  
Residential Segregation ◽  
Social Cohesion ◽  
Qualitative Interviews ◽  
Multilevel Regression ◽  
Cross Sectional ◽  
Racial Residential Segregation ◽  
Older African Americans

Physical inactivity is one of the factors contributing to disproportionate disease rates among older African Americans. Previous literature indicates that older African Americans are more likely to live in racially segregated neighborhoods and that racial residential segregation is associated with limited opportunities for physical activity. A cross-sectional mixed methods study was conducted guided by the concept of therapeutic landscapes. Multilevel regression analyses demonstrated that racial residential segregation was associated with more minutes of physical activity and greater odds of meeting physical activity recommendations. Qualitative interviews revealed the following physical activity related themes: aging of the neighborhood, knowing your neighbors, feeling of safety, and neighborhood racial identity. Perceptions of social cohesion enhanced participants’ physical activity, offering a plausible explanation to the higher rates of physical activity found in this population. Understanding how social cohesion operates within racially segregated neighborhoods can help to inform the design of effective interventions for this population.

scholarly journals Are socioenvironmental factors associated with psychotic symptoms in people with first-episode psychosis? A cross-sectional study of a West London clinical sample

BMJ Open ◽  
2019 ◽  
Vol 9 (9) ◽  
pp. e030448 ◽  
Author(s):  
Marc S Tibber ◽  
James B Kirkbride ◽  
Stanley Mutsatsa ◽  
Isobel Harrison ◽  
Thomas R E Barnes ◽  
...  
Keyword(s):  
Income Inequality ◽  
First Episode Psychosis ◽  
Psychotic Symptoms ◽  
First Episode ◽  
Cross Sectional ◽  
Specific Symptom ◽  
Individual Level ◽  
Episode Psychosis ◽  
Neighbourhood Level ◽  
Symptom Scores

ObjectivesTo determine whether neighbourhood-level socioenvironmental factors including deprivation and inequality predict variance in psychotic symptoms after controlling for individual-level demographics.DesignA cross-sectional design was employed.SettingData were originally collected from secondary care services within the UK boroughs of Ealing, Hammersmith and Fulham, Wandsworth, Kingston, Richmond, Merton, Sutton and Hounslow as part of the West London First-Episode Psychosis study.ParticipantsComplete case analyses were undertaken on 319 participants who met the following inclusion criteria: aged 16 years or over, resident in the study’s catchment area, experiencing a first psychotic episode, with fewer than 12 weeks’ exposure to antipsychotic medication and sufficient command of English to facilitate assessment.Outcome measuresSymptom dimension scores, derived from principal component analyses of the Scale for the Assessment of Positive Symptoms and Scale for the Assessment of Negative Symptoms, were regressed on neighbourhood-level predictors, including population density, income deprivation, income inequality, social fragmentation, social cohesion, ethnic density and ethnic fragmentation, using multilevel regression. While age, gender and socioeconomic status were included as individual-level covariates, data on participant ethnicity were not available.ResultsHigher income inequality was associated with lower negative symptom scores (coefficient=−1.66, 95% CI −2.86 to –0.46, p<0.01) and higher levels of ethnic segregation were associated with lower positive symptom scores (coefficient=−2.32, 95% CI −4.17 to –0.48, p=0.01) after adjustment for covariates.ConclusionsThese findings provide further evidence that particular characteristics of the environment may be linked to specific symptom clusters in psychosis. Longitudinal studies are required to begin to tease apart the underlying mechanisms involved as well as the causal direction of such associations.

Abstract 14363: Clustering of Multiple Cardiometabolic Risk Factors by Race/Ethnicity and Age

Circulation ◽  
2020 ◽  
Vol 142 (Suppl_3) ◽  
Author(s):  
Olivia P Kizzee ◽  
Joan C Lo
Keyword(s):  
Risk Factor ◽  
Weight Status ◽  
Cardiometabolic Risk ◽  
Chinese Americans ◽  
Atherosclerotic Cardiovascular Disease ◽  
Cardiometabolic Risk Factor ◽  
Cross Sectional ◽  
Asian Ethnicity ◽  
Race Ethnicity ◽  
Electronic Health

Introduction: Atherosclerotic cardiovascular disease (ASCVD) is the leading cause of death among Americans. The burden of cardiometabolic risk factor clustering in ethnic subgroups is not well described for US Asians compared to other race/ethnicities. Methods: This cross-sectional study was conducted using electronic health data for White (N=634,200), Black (N=85,156), Hispanic (N=188,071), Filipino (N=78,000) and Chinese (N=72,545) Kaiser Permanente Northern California health plan members in 2016 who were aged 40-84y and had weight status assessed. We examined the proportions of men and women in each racial/ethnic group with clustered cardiometabolic risks (CCR), defined as having diabetes, hypertension, and obesity. Diabetes mellitus (DM) was based on a clinical DM diagnosis, lab criteria, or receipt of DM pharmacotherapy. Hypertension was defined by clinical diagnosis. Obesity was characterized by WHO standard (BMI ≥30 kg/m 2 ) and Asian-specific (BMI ≥27.5 kg/m 2 ) thresholds. Results: CCR prevalence varied by race/ethnicity, age, and the BMI criteria used for obesity (standard or Asian threshold). Use of the Asian threshold resulted in Filipinos having CCR prevalence that approached Blacks and Hispanics across all age groups (Figure). The Asian criterion nearly doubled the proportion of at-risk Filipinos, particularly older adults aged 65-84y. Filipinos had more than 2x higher CCR prevalence compared to Chinese. Among all ethnic groups except for Blacks, men were more likely than women to have CCR. Conclusion: Using an Asian-specific BMI obesity threshold, Filipino-Americans have a higher prevalence of cardiometabolic risk factor clustering than Chinese-Americans, resembling that of Blacks and Hispanics. Identifying Asian ethnicity in electronic health records could help facilitate earlier metabolic assessment and management to further reduce CVD burden, which may be especially important for men.

Natural experiment examining the longitudinal association between change in residential segregation and youth cardiovascular health across race/ethnicity and gender in the USA

2018 ◽  
Vol 72 (7) ◽  
pp. 595-604 ◽  
Author(s):  
Emily M D’Agostino ◽  
Hersila H Patel ◽  
Zafar Ahmed ◽  
Eric Hansen ◽  
M Sunil Mathew ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Residential Segregation ◽  
Natural Experiment ◽  
Cardiovascular Health ◽  
Reference Group ◽  
Geographic Mobility ◽  
Individual Level ◽  
Race Ethnicity ◽  
And Gender ◽  
Ethnicity And Gender

BackgroundIdentifying how racial/ethnic residential segregation and mobility may impact health can guide innovative strategies for reducing youth disparities.MethodsThis natural experiment examined the association between change in residential segregation and cardiovascular health outcomes across race/ethnicity and gender for youth (n=2250, mean age 9.1 years, 54% male; 51% Hispanic, 49% non-Hispanic black (NHB); 49% high area poverty) attending a multisite park-based afterschool fitness programme in Florida, USA. Two-level generalised linear mixed models with random intercepts for park effects were fit to test the change in segregation–cardiovascular health association over two school years.ResultsAfter covariate adjustment (individual-level gender, race/ethnicity, age, time and park-area poverty), greater improvements in cardiovascular health including body mass index percentile, sum of skinfold thicknesses, systolic/diastolic blood pressure percentiles and 400 m run time were found for youth who attended the program in a less segregated area compared with their home area (p<0.05 for all outcomes). NHB girls showed the greatest cardiovascular health improvements. Specifically, compared with the reference group (no change in segregation), skinfold thicknesses and systolic blood pressure percentiles decreased 17% (incidence rate ratio (IRR) 95% CI 0.81 to 0.86) and 16% (IRR 95% CI 0.82 to 0.87), respectively, versus 1% increase for both outcomes (IRR 95% CI 0.98 to 1.05) and (IRR 95% CI 0.98 to 1.05), respectively, for movement to less versus more segregated areas.ConclusionIn light of a continually expanding youth obesity epidemic, the global effort to reduce health inequities may be supported through Parks and Recreation Departments given potential to expand geographic mobility for low resource subgroups.

Creativity in Sociocultural Systems

2019 ◽  
pp. 269-284
Author(s):  
Dean Keith Simonton
Keyword(s):  
Macro Level ◽  
Historical Overview ◽  
Creative Activity ◽  
Cross Sectional ◽  
Individual Level ◽  
Short And Long Term ◽  
The Cross ◽  
Sociocultural Systems

Although psychologists typically see creativity as an individual-level event, sociologists and cultural anthropologists are more likely to view it as a sociocultural phenomenon. This phenomenon takes place at the level of relatively large and enduring collectives, such as cultures, nations, and even whole civilizations. This chapter reviews the extensive research on such macro-level creativity. The review begins with a historical overview before turning to the cross-sectional research on the creative Ortgeist, a subject that encompasses the factors that influence the relative creativity of both preliterate cultures and entire modern nations. From there the chapter turns to role of the Zeitgeist in affecting the creativity of civilizations across time—the rise and fall of creative activity. This research examines both quantitative and qualitative causes that operate both short- and long-term.

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