Diez Roux AV, Merkin SS, et al. Neighborhood of residence and incidence of coronary heart disease. New England Journal of Medicine. 2001;345:99-106.
The authors examined the relation between characteristics of neighborhoods and the incidence of coronary heart disease. Participants were sampled from the four communities were 45-64 years of age at baseline. As proxies for neighborhoods, the researchers used block groups containing an average of 1,000 people, as defined by the U.S. census. They constructed a summary score for the socioeconomic environment of each neighborhood that included information about wealth and income, education, and occupation.
During a median of 9.1 years of follow-up, 615 coronary events occurred in 13,009 participants. Controlling for personal socioeconomic indicators, the researchers found that individuals living in the most disadvantaged neighborhoods were more likely to develop coronary heart disease than were those living in the most advantaged neighborhoods. They suggest that neighborhood characteristics may have contributed to the development of cardiovascular risk factors and cardiovascular disease. Finally, the authors discuss the need to understand health disparities by looking at social inequalities, and they recommend both "enhancing the social and psychological resources of individual people, and improving the quality of neighborhoods and communal life."
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