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A novel approach for measuring residential socioeconomic factors associated with cardiovascular and metabolic health

Journal of Exposure Science & Environmental Epidemiology volume 27, pages 281–289 (2017)Cite this article

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Abstract

Individual-level characteristics, including socioeconomic status, have been associated with poor metabolic and cardiovascular health; however, residential area-level characteristics may also independently contribute to health status. In the current study, we used hierarchical clustering to aggregate 444 US Census block groups in Durham, Orange, and Wake Counties, NC, USA into six homogeneous clusters of similar characteristics based on 12 demographic factors. We assigned 2254 cardiac catheterization patients to these clusters based on residence at first catheterization. After controlling for individual age, sex, smoking status, and race, there were elevated odds of patients being obese (odds ratio (OR)=1.92, 95% confidence intervals (CI)=1.39, 2.67), and having diabetes (OR=2.19, 95% CI=1.57, 3.04), congestive heart failure (OR=1.99, 95% CI=1.39, 2.83), and hypertension (OR=2.05, 95% CI=1.38, 3.11) in a cluster that was urban, impoverished, and unemployed, compared with a cluster that was urban with a low percentage of people that were impoverished or unemployed. Our findings demonstrate the feasibility of applying hierarchical clustering to an assessment of area-level characteristics and that living in impoverished, urban residential clusters may have an adverse impact on health.

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Acknowledgements

We would like to acknowledge Drs Marie Lynn Miranda and Cavin K Ward-Caviness for their involvement in the geocoding of the CATHGEN patients. We thank all of the participants in the CATHGEN study, and we acknowledge the essential contributions of the faculty and staff of the Duke Cardiac Catheterization Lab, the Duke Databank for Cardiovascular Disease, and the Duke Center for Human Genetics for their contributions to this manuscript. This work was supported by United States Environmental Protection Agency internal funds; the EPA Cooperative Agreement with the Center for Environmental Medicine, Asthma, and Lung Biology at the University of North Carolina (CR83346301); the National Institutes of Environmental Health Sciences (T32ES007126); a UNC Golberg Fellowship; the National Institutes of Health (HL73042, HL36587, HL095987); an award from the Neurosciences Education and Research Foundation (Encinitas, CA); and the Health Effects Institute (4946-RFPA10-3/14-7).

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Authors and Affiliations

  1. Curriculum in Toxicology, University of North Carolina, Chapel Hill, North Carolina, USA

    Jaime E Mirowsky

  2. Center for Environmental Medicine, Asthma, and Lung Biology, University of North Carolina, Chapel Hill, North Carolina, USA

    Jaime E Mirowsky

  3. National Health and Environmental Effects Laboratory, US Environmental Protection Agency, Chapel Hill, North Carolina, USA

    Robert B Devlin, David Diaz-Sanchez, Wayne Cascio, Shannon C Grabich & Lucas Neas

  4. Duke Molecular Physiology Institute, Duke University Medical Center, Durham, North Carolina, USA

    Carol Haynes, Colette Blach, Elizabeth R Hauser, Svati Shah & William Kraus

  5. Department of Biostatistics and Bioinformatics, Duke University Medical Center, Durham, North Carolina, USA

    Elizabeth R Hauser

  6. Cooperative Studies Program Epidemiology Center, Durham Veterans Affairs Medical Center, Durham, North Carolina, USA

    Elizabeth R Hauser

  7. Division of Cardiology, Department of Medicine, School of Medicine, Duke University, Durham, North Carolina, USA

    Svati Shah & William Kraus

  8. National Center for Environmental Assessment, US Environmental Protection Agency, Chapel Hill, North Carolina, USA

    Kenneth Olden

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Correspondence to Lucas Neas.

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Research described in this article was conducted under contract to the Health Effects Institute (HEI), and organization jointly funded by the United States Environmental Protection Agency (EPA) (Assistance Award No. R-82811201) and certain motor vehicle and engine manufacturers. The contents of this article do not necessarily reflect the views of HEI, or its sponsors, nor do they necessarily reflect the view and policies of the EPA or motor vehicle and engine manufacturers. Mention of trade names or commercial products does not constitute endorsement or recommendation for use.

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Mirowsky, J., Devlin, R., Diaz-Sanchez, D. et al. A novel approach for measuring residential socioeconomic factors associated with cardiovascular and metabolic health. J Expo Sci Environ Epidemiol 27, 281–289 (2017). https://doi.org/10.1038/jes.2016.53

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