Neighborhood disparities in incident hospitalized myocardial infarction in four U.S. communities: the ARIC surveillance study.

TitleNeighborhood disparities in incident hospitalized myocardial infarction in four U.S. communities: the ARIC surveillance study.
Publication TypeJournal Article
Year of Publication2009
AuthorsRose KM, Suchindran CM, Foraker RE, Whitsel EA, Rosamond WD, Heiss G, Wood JL
JournalAnn Epidemiol
Volume19
Issue12
Pagination867-74
Date Published2009 Dec
ISSN1873-2585
KeywordsAdult, African Americans, Aged, Cluster Analysis, European Continental Ancestry Group, Female, Health Status Disparities, Hospitalization, Humans, Incidence, Male, Maryland, Middle Aged, Minnesota, Mississippi, Myocardial Infarction, North Carolina, Population Surveillance, Poverty Areas, Risk Factors, Urban Population
Abstract

PURPOSE: Hospital-based surveillance of myocardial infarction (MI) in the United States (U.S.) typically includes age, gender, and race, but not socioeconomic status (SES). We examined the association between neighborhood median household income (nINC) and incident hospitalized MI in four U.S. communities (1993-2002).

METHODS: Average annual indirect age-standardized MI rates were calculated using community-specific and community-wide nINC tertiles. Poisson generalized linear mixed models were used to calculate MI incidence rate ratios by tertile of census tract nINC (high nINC group referent).

RESULTS: Within community, and among all race-gender groups, those living in low nINC neighborhoods had an increased risk of MI compared to those living in high nINC neighborhoods. This association was present when both community-specific and community-wide nINC cut points were used. Blacks and, to a lesser extent, women, were disproportionately represented in low nINC neighborhoods, resulting in a higher absolute burden of MI in blacks and women living in low compared with high nINC neighborhoods.

CONCLUSIONS: These findings suggest a need for the joint consideration of racial, gender, and social disparities in interventions aimed at preventing coronary heart disease.

DOI10.1016/j.annepidem.2009.07.092
Alternate JournalAnn Epidemiol
PubMed ID19815428
PubMed Central IDPMC2787853
Grant ListN01HC55020 / HL / NHLBI NIH HHS / United States
N01HC55018 / HL / NHLBI NIH HHS / United States
N01-HC-55022 / HC / NHLBI NIH HHS / United States
N01-HC-55016 / HC / NHLBI NIH HHS / United States
R01 HL080287-03 / HL / NHLBI NIH HHS / United States
N01HC55022 / HL / NHLBI NIH HHS / United States
1R01HL080287 / HL / NHLBI NIH HHS / United States
N01-HC-55021 / HC / NHLBI NIH HHS / United States
N01HC55015 / HL / NHLBI NIH HHS / United States
R01 HL080287 / HL / NHLBI NIH HHS / United States
N01-HC-55019 / HC / NHLBI NIH HHS / United States
N01-HC-55015 / HC / NHLBI NIH HHS / United States
N01-HC-55020 / HC / NHLBI NIH HHS / United States
N01HC55016 / HL / NHLBI NIH HHS / United States
N01HC55019 / HL / NHLBI NIH HHS / United States
R24 HD050924 / HD / NICHD NIH HHS / United States
N01-HC-55018 / HC / NHLBI NIH HHS / United States
N01HC55021 / HL / NHLBI NIH HHS / United States