Neighbourhood racial/ethnic residential segregation and cardiometabolic risk: The multiethnic study of atherosclerosis

Stephanie L. Mayne*, Margaret T. Hicken, Sharon Stein Merkin, Teresa E. Seeman, Kiarri N. Kershaw, D. Phuong Do, Anjum Hajat, Ana V. Diez Roux

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

6 Scopus citations

Abstract

Background Racial residential segregation has been linked to adverse health outcomes, but associations may operate through multiple pathways. Prior studies have not examined associations of neighbourhood-level racial segregation with an index of cardiometabolic risk (CMR) and whether associations differ by race/ethnicity. Methods We used data from the Multi-Ethnic Study of Atherosclerosis to estimate cross-sectional and longitudinal associations of baseline neighbourhood-level racial residential segregation with a composite measure of CMR. Participants included 5015 non-Hispanic black, non-Hispanic white and Hispanic participants aged 45-84 years old over 12 years of follow-up (2000-2012). We used linear mixed effects models to estimate race-stratified associations of own-group segregation with CMR at baseline and with the rate of annual change in CMR. Models were adjusted for sociodemographics, medication use and individual-level and neighbourhood-level socioeconomic status (SES). Results In models adjusted for sociodemographics and medication use, high baseline segregation was associated with higher baseline CMR among blacks and Hispanics but lower baseline CMR among whites. Individual and neighbourhood-level SES fully explained observed associations between segregation and CMR for whites and Hispanics. However, associations of segregation with CMR among blacks remained (high vs low segregation: mean difference 0.17 SD units, 95% CI 0.02 to 0.32; medium vs low segregation: mean difference 0.18 SD units, 95% CI 0.03 to 0.33). Baseline segregation was not associated with change in CMR index scores over time. Conclusion Associations of own-group racial residential segregation with CMR varied by race/ethnicity. After accounting for SES, living in a more segregated neighbourhood was associated with greater risk among black participants only.

Original languageEnglish (US)
Pages (from-to)26-33
Number of pages8
JournalJournal of Epidemiology and Community Health
Volume73
Issue number1
DOIs
StatePublished - Jan 1 2019

Keywords

  • longitudinal studies
  • neighborhood/place
  • social epidemiology

ASJC Scopus subject areas

  • Epidemiology
  • Public Health, Environmental and Occupational Health

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