Assessing the spatial heterogeneity in black-white differences in optimal cardiovascular health and the impact of individual- and neighborhood-level risk factors: The Multi-Ethnic Study of Atherosclerosis (MESA)

Loni Philip Tabb, Leslie A. McClure, Angel Ortiz, Steven Melly, Miranda R. Jones, Kiarri N. Kershaw, Ana V.Diez Roux

Research output: Contribution to journalArticle

Abstract

Racial disparities in cardiovascular health (CVH) continue to remain a public health concern in the United States. We use unique population-based data from the Multi-Ethnic Study of Atherosclerosis cohort to explore the black-white differences in optimal CVH. Utilizing geographically weighted regression methods, we assess the spatial heterogeneity in black-white differences in optimal CVH and the impact of both individual- and neighborhood-level risk factors. We found evidence of significant spatial heterogeneity in black-white differences that varied within and between the five sites. Initial models showed decreased odds of optimal CVH for blacks that ranged from 60% to 70% reduced odds – with noticeable variation of these decreased odds within each site. Adjusting for risk factors resulted in reductions in the black-white differences in optimal CVH. Further understanding of the reasons for spatial heterogeneities in black-white differences in nationally representative cohorts may provide important clues regarding the drivers of these differences.

Original languageEnglish (US)
Article number100332
JournalSpatial and Spatio-temporal Epidemiology
Volume33
DOIs
StatePublished - Jun 2020

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Keywords

  • Cardiovascular health
  • Disparities
  • Spatial heterogeneity

ASJC Scopus subject areas

  • Epidemiology
  • Geography, Planning and Development
  • Infectious Diseases
  • Health, Toxicology and Mutagenesis

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