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)

Publication date: Available online 7 February 2020Source: Spatial and Spatio-temporal EpidemiologyAuthor(s): Loni Philip Tabb, Leslie A. McClurea, Angel Ortiz, Steven Mellyb, Miranda R. Jonesc, Kiarri N. Kershawd, Ana V.Diez RouxaAbstractRacial 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.
Source: Spatial and Spatio-temporal Epidemiology - Category: Epidemiology Source Type: research