Abstract MP36: Associations of Chronic Individual- and Neighborhood-Level Stressors with Incident Coronary Heart Disease (CHD): The Multi-Ethnic Study of Atherosclerosis (MESA)

Circulation ◽  
2014 ◽  
Vol 129 (suppl_1) ◽  
Author(s):  
Kiarri N Kershaw ◽  
Ana V Diez Roux ◽  
Alain Bertoni ◽  
Mercedes R Carnethon ◽  
Susan A Everson-Rose ◽  
...  

Background: Several individual-level measures of stress have been linked to incident CHD in prospective studies, but less attention has focused on the influence of neighborhood-level stressors. We assessed prospective associations of individual- and neighborhood-level stressors with incident CHD. Methods: MESA participants were aged 45-84 years at baseline (2000-2002). Analyses were conducted separately for those with complete data on individual- (n=6678) and neighborhood-level stressors (n=6105). Missing values on covariates were imputed with multiple imputation. Baseline individual-level sources of stress were assessed using the chronic burden scale, a measure of the presence and perceived stressfulness of ongoing health, job, relationship, and financial problems lasting over 6 months. Survey-based neighborhood safety (3 items) and neighborhood social cohesion (5 items) were examined as neighborhood-level sources of chronic stress. Each participant’s neighborhood safety and neighborhood social cohesion scores were constructed using Empirical Bayes estimation techniques that incorporated the responses of other MESA participants and a sample of non-participants living within a mile of that participant. Scores for each individual- and neighborhood-level stress measures were categorized into approximate tertiles (low, medium, and high) for analyses. CHD was defined as nonfatal myocardial infarction, resuscitated cardiac arrest, or CHD death. Median follow-up time was 8.5 years. Multivariable Cox proportional hazard models were used to estimate associations of high chronic burden, low neighborhood cohesion, and low neighborhood safety with incident CHD after adjusting for sociodemographic characteristics as well as behavioral and biological risk factors. Results: Participants in the high chronic burden category had 55% higher risk of incident CHD (hazard ratio (HR): 1.55; 95% confidence interval (CI): 1.11, 2.15) than those in the low category after adjusting for age, race/ethnicity, gender, education, income, marital status and field center. Findings attenuated slightly but remained significant with further adjustment for hypercholesterolemia, hypertension, diabetes, body mass index, physical activity, current smoking, and current alcohol use (HR: 1.47; 95% CI: 1.03, 2.00). Neither low (vs. high) neighborhood cohesion (HR: 1.23; 95% CI: 0.74, 2.06) nor low (vs. high) neighborhood safety (HR: 1.12; 95% CI: 0.68, 1.84) was associated with CHD in sociodemographic-adjusted models. Conclusions: Individual-level sources of stress were more strongly associated with incident CHD than neighborhood-level stressors.

2021 ◽  
pp. 193672442110430
Author(s):  
Victoria A. Reynolds ◽  
Manacy Pai

The purpose of this study is to examine (a) the association between cancer diagnosis and psychological distress and (b) the extent to which this association is moderated by perceptions of neighborhood social cohesion. Data are drawn from the 2013 wave of the National Health Interview Survey (NHIS), a nationally representative survey on broad health topics. We employ ordinary least squares (OLS) regression to examine the links between cancer, neighborhood cohesion, and distress. Findings reveal no statistically significant difference in psychological distress between women with breast and cervical cancer. However, neighborhood social cohesion does moderate the effect of cancer on distress. While perceptions of neighborhood cohesion do not affect levels of psychological distress among women with breast cancer, perceived connectedness with neighbors translates into significantly lower levels of mental distress among women diagnosed with cervical cancer.


2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Jesse J. Plascak ◽  
Adana A. M. Llanos ◽  
Stephen J. Mooney ◽  
Andrew G. Rundle ◽  
Bo Qin ◽  
...  

Abstract Background Mounting evidence supports associations between objective neighborhood disorder, perceived neighborhood disorder, and health, yet alternative explanations involving socioeconomic and neighborhood social cohesion have been understudied. We tested pathways between objective and perceived neighborhood disorder, perceived neighborhood social cohesion, and socioeconomic factors within a longitudinal cohort. Methods Demographic and socioeconomic information before diagnosis was obtained at interviews conducted approximately 10 months post-diagnosis from participants in the Women’s Circle of Health Follow-up Study – a cohort of breast cancer survivors self-identifying as African American or Black women (n = 310). Neighborhood perceptions were obtained during follow-up interviews conducted approximately 24 months after diagnosis. Objective neighborhood disorder was from 9 items audited across 23,276 locations using Google Street View and scored to estimate disorder values at each participant’s residential address at diagnosis. Census tract socioeconomic and demographic composition covariates were from the 2010 U.S. Census and American Community Survey. Pathways to perceived neighborhood disorder were built using structural equation modelling. Model fit was assessed from the comparative fit index and root mean square error approximation and associations were reported as standardized coefficients and 95% confidence intervals. Results Higher perceived neighborhood disorder was associated with higher objective neighborhood disorder (β = 0.20, 95% CI: 0.06, 0.33), lower neighborhood social cohesion, and lower individual-level socioeconomic factors (final model root mean square error approximation 0.043 (90% CI: 0.013, 0.068)). Perceived neighborhood social cohesion was associated with individual-level socioeconomic factors and objective neighborhood disorder (β = − 0.11, 95% CI: − 0.24, 0.02). Conclusion Objective neighborhood disorder might be related to perceived disorder directly and indirectly through perceptions of neighborhood social cohesion.


Circulation ◽  
2018 ◽  
Vol 137 (suppl_1) ◽  
Author(s):  
Rosenda Murillo ◽  
Layton M Reesor ◽  
Daphne C Hernandez ◽  
Ezemenari M Obasi

Introduction: Neighborhood walkability and neighborhood social cohesion have been shown to contribute to physical activity. However, limited research has examined neighborhood social cohesion as a moderator in the association between neighborhood walkability and aerobic physical activity among Latino adults. We examined associations of neighborhood walkability using measures assessing built environment and safety, with meeting the aerobic activity guideline among a large nationally representative diverse sample of Latino adults. Methods: We used cross-sectional data from 4,765 NHIS 2015 Latino participants 18 years of age and older. Neighborhood walkability was assessed based on self-reported measures of built environment (e.g., presence of sidewalks, presence of paths/trails) and neighborhood safety (e.g., presence of traffic, crime). A neighborhood walkability score was created by combining the built environment and neighborhood safety items, with a higher score indicating higher walkability. Aerobic activity was categorized as meeting versus not meeting the aerobic activity guideline, based on 2008 Physical Activity Guidelines for Americans . Neighborhood social cohesion was measured based on self-reported items assessing perceived neighborhood social cohesion. Survey logistic regression was used to compute odds ratios [OR] and 95% confidence intervals [CI], with covariates adjusting for age, sex, education, acculturation, and neighborhood social cohesion. Effect modification by neighborhood social cohesion was tested by inclusion of a neighborhood walkability and neighborhood social cohesion interaction term. Results: On average the sample was 44 years old, 44% were male, 36% had less than a high school education, and 58% were foreign-born. After adjusting for age, sex, education, and acculturation, a one-unit higher neighborhood walkability score was associated with significantly higher odds of meeting the aerobic physical activity guideline (OR: 1.08; 95% CI: 1.05, 1.11), relative to not meeting the aerobic activity guideline. After adding neighborhood social cohesion to the adjusted model, the association between neighborhood walkability and meeting the aerobic activity guideline was slightly attenuated, but remained significant (OR: 1.07; 95% CI: 1.03, 1.11). Results from the effect modification test indicated that the neighborhood walkability and neighborhood social cohesion interaction term was not significant. Conclusions: These findings suggest that neighborhood walkability contributes to meeting the aerobic physical activity guideline among Latino adults. However, neighborhood social cohesion does not moderate the association between neighborhood walkability and meeting the aerobic activity guideline.


2014 ◽  
Vol 06 (02n03) ◽  
pp. 1450008 ◽  
Author(s):  
STAN LIPOVETSKY

Discrete choice modeling (DCM) is widely used in economics, social studies, and marketing research for estimating utilities and preference probabilities of multiple alternatives. Data for the model is elicited from the respondents who are presented with several sets of items characterized by various attributes, and each respondent chooses the best alternative in each set. Estimation of utilities is usually performed in a multinomial-logit (MNL) modeling and software for Hierarchical Bayesian (HB) technique is usually applied to find individual utilities by iterative estimations. This paper describes an easy and convenient empirical Bayesian way to construct priors and combine them with the likelihood on individual level data. This allows the modeler to obtain posterior estimation of MNL utilities in noniterative evaluations. Logistic modeling for the posterior frequencies is performed using the linear link of their logarithm of odds that clarifies the results of DCM modeling. The problem of overfitting is considered and the optimum balance between signal and noise in the precision of individual prediction and the smoothing of overall data is suggested. Actual market research data are used and the results are discussed.


2017 ◽  
Author(s):  
Ruud Koopmans ◽  
Merlin Schaeffer

The question whether ethnic diversity is associated with declining social cohesion has produced much controversy. We maintain that more attention must be paid to cognitive mechanisms to move the debate ahead. Using survey data from 938 localities in Germany, France, and the Netherlands, we explore a crucial individual-level mechanism: perceptions of diversity. We not only consider perceptions of the amount, but also of the qualitative nature of diversity. By asking about various qualitative aspects of diversity, we test the cognitive salience of three explanations that have been proposed in the literature for negative diversity effects: out-group biases, asymmetric preferences and coordination problems. We show that all three mechanisms matter. Perceptions both mediate statistical diversity effects, and have important explanatory power of their own. Moreover, we are able to address the question to what extend the relationship of perceived diversity and neighborhood social cohesion varies across policy contexts. Based on assumptions in the literature about positive impacts of inclusive and culturally pluralist immigrant integration policy approaches, we hypothesize that ethno-cultural diversity is less negatively related to neighborhood social cohesion in more inclusive policy contexts. Our results provide partial support for this hypothesis as perceived diversity has a significantly stronger negative impact on neighborhood cohesion in Germany.


2019 ◽  
Vol 3 (Supplement_1) ◽  
pp. S589-S590
Author(s):  
Wei Zhang ◽  
Sizhe Liu ◽  
Keqing Zhang ◽  
Bei Wu

Abstract Few studies have examined the association of social environment and well-being among Chinese older adults, the fastest growing aging population across all racial/ethnic groups in the U.S. To address this gap, the current study aims to examine the associations of neighborhood social cohesion with psychological distress and life satisfaction as well as the mediating role of resilience and the moderating roles of gender and place of birth using data collected among 430 Chinese older adults in Honolulu. Results show that neighborhood cohesion was significantly associated with both distress and life satisfaction, with resilience being a significant mediator. The association between neighborhood cohesion and distress was moderated by birth place such that the protecting effects of neighborhood cohesion on distress were only salient for the U.S.-born. Our findings indicate the importance of a cohesive social environment in shaping well-being of U.S. Chinese older adults, the U.S.-born in particular, living in Hawai’i.


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