Neighborhood affects risk of heart attack
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The economic situation of people’s neighborhoods may affect their risk of suffering a heart attack, a study in Sweden suggests.
Researchers found that among 3,610 adults living near the urban area of Stockholm, those living in lower-income neighborhoods had a higher rate of heart attack than those in more affluent areas. And the risk was not fully explained by a person’s own income, education and occupation - factors that many studies have linked to disease and death risk.
The implication, the researchers report in the journal Epidemiology, is that neighborhood characteristics can add to the health effects of an individual’s economic situation.
People with lower incomes and education levels generally have higher rates of heart disease risk factors, like smoking, inactivity and obesity, and so these problems are more prevalent in low-income neighborhoods.
But, the study authors write, people’s living environments also shape their attitudes and behavior, meaning that even if their personal income goes up, the neighborhood “context” could still have health effects.
In addition, the infrastructure and resources in a neighborhood could be important factors in heart attack risk.
For the study, researchers led by Dr. Maria K. Stjarne of Stockholm University and the Karolinska Institute analyzed data on 3,610 middle-aged and older adults who had either recently suffered a first heart attack or were free of heart disease.
Neighborhood status was defined by the typical household income in a residential area, as well as the neighborhood diversity - whether people with similar incomes were clustered together or whether there was a greater mix of incomes.
Overall, women in low-income neighborhoods were 88 percent more likely to have had a heart attack than those in high-income areas. Men in low-income areas had a 52 percent greater risk of heart attack.
There was some evidence that income diversity in a neighborhood mattered, with men in uniformly low-income areas having a greater risk of heart attack than those in more mixed neighborhoods that included households with high incomes. But there was no clear-cut pattern of neighborhood diversity affecting heart attack risk overall, the researchers note.
Still, Stjarne and her colleagues say, the findings do not negate the potential importance of neighborhood diversity on people’s health. Many have argued that low-income families benefit, health-wise and in other ways, when they live among middle- and high-income neighbors.
SOURCE: Epidemiology, January 2006.
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