Article Level: Basic
News
Heart Disease Risk
Linked to Where You
Live
Erin R. King, Medical Writer
July 11 (Medscape Health)
Where you live could influence
your risk of heart disease,
especially if you live in a
so-called "disadvantaged"
neighborhood, according to a
new study.
Researchers analyzed data from
over 13,000 people who
participated in a large study of
heart disease. They compared
the participants' neighborhoods on the basis of
residents'
incomes, levels of education, and occupations, and also
looked at individuals' risk factors.
Even if an individual's income, education, and
occupation
were in the range thought to positively impact their
heart
health, those people who lived in disadvantaged
neighborhoods were still more likely to have heart
disease
than people just like them who lived in better-off
neighborhoods.
"This is an important study because it confirms what
some
people have suspected--that the neighborhood you live
in
does relate to your getting heart disease eventually,"
says
study co-author Lloyd Chambless, PhD, research
professor of biostatistics at the University of North
Carolina at Chapel Hill School of Public Health, in a
release.
"It doesn't necessarily tell us why, but it suggests
that
another way of preventing heart disease might be on a
neighborhood level," he notes.
But learning why is important, write the authors--led
by
Ana V. Diez Roux, MD, PhD, assistant professor of
medicine and public health at Columbia
University--because, "At a time of growing economic
segregation of residential areas, differences among
places may become even more relevant to explanations of
disparities in health."
Some of the factors that may play a role in the
increased
incidence of heart disease in some areas, they say,
include the amount of tobacco advertising in a
neighborhood, whether or not people have access to and
can afford healthy foods, and the availability of areas
to
get some exercise outdoors.
The presence of stress-causing noise, violence, and the
stress of poverty itself may also contribute, the
authors
write.
The effect of the neighborhood on heart disease risk
was
found for both African Americans and Caucasians--the
two ethnic groups that made up the majority of study
participants--but the association was not as strong for
African Americans. However, the authors note, this
finding
should be "interpreted with caution" because of
differences in neighborhood characteristics.
Inequalities in health are present throughout the
world,
whether you compare different nations or different
sections of the same city, says Michael Marmot, PhD,
professor in the department of epidemiology and public
health at University College London. Marmot is author
of
an editorial that appears, along with the study from
Diez
Roux's group, in the July 12 issue of the New England
Journal of Medicine.
The study suggests answers to some tough questions,
Marmot writes. For example;
Does the social environment work to create
differences in health? A
Do some areas have worse health status because
poor people live there, or is something else at
work?
While it seems that the socioeconomic makeup of a
community is related to the health of its residents,
it's not
as simple as assuming that lack of money means lack of
good health, Marmot says.
"There are poor countries that achieve good health at
low
cost," he notes. For instance, the average life
expectancy
is more than 77 years for people living in China, Sri
Lanka, and the state of Kerala in southern India, where
the
average person makes less than $1,000 a year.
However, in the Harlem section of New York City, where
the 1990 median family income was more than $24,000
annually, only about 37% of African American men can
expect to reach their 65th birthday, he writes.
"As research develops, it will become important to ask
the
question of how an understanding of health disparities
might help correct some of the problems of deep-seated
social inequalities," Marmot writes.
The findings of the study from Diez Roux and her group,
he says, "suggest two potential targets of
intervention:
enhancing the social and psychological resources of
individual people, and improving the quality of
neighborhoods and communal life."
Erin King is a Connecticut-based freelance writer and a
frequent
contributor to Medscape Health. Her work has also
appeared in
several regional newspapers.
Source: Medscape Health
Copyright:
© 2001 Medscape, Inc.
Posted On Site: Jul. 2001
Publication Date: Jul. 2001
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