Neighborhood environmental health and premature death from cardiovascular disease

Anne H. Gaglioti, Junjun Xu, Latrice Rollins, Peter Baltrus, Laura Kathryn O'Connell, Dexter L. Cooper, Jammie Hopkins, Nisha D. Botchwey, Tabia Henry Akintobi

Research output: Contribution to journalArticlepeer-review

28 Scopus citations


Introduction Cardiovascular disease (CVD) is the leading cause of death in the United States and disproportionately affects racial/ethnic minority groups. Healthy neighborhood conditions are associated with increased uptake of health behaviors that reduce CVD risk, but minority neighborhoods often have poor food access and poor walkability. This study tested the community-driven hypothesis that poor access to food at the neighborhood level and poor neighborhood walkability are associated with racial disparities in premature deaths from CVD. Methods We examined the relationship between neighborhood-level food access and walkability on premature CVD mortality rates at the census tract level for the city of Atlanta using multivariable logistic regression models. We produced maps to illustrate premature CVD mortality, food access, and walkability by census tract for the city. Results We found significant racial differences in premature CVD mortality rates and geographic disparities in food access and walkability among census tracts in Atlanta. Improved food access and walkability were associated with reduced overall premature CVD mortality in unadjusted models, but this association did not persist in models adjusted for census tract population composition and poverty. Census tracts with high concentrations of minority populations had higher levels of poor food access, poor walkability, and premature CVD mortality. Conclusion This study highlights disparities in premature CVD mortality and neighborhood food access and walkability at the census tract level in the city of Atlanta. Improving food access may have differential effects for subpopulations living in the same area. These results can be used to calibrate neighborhood-level interventions, and they highlight the need to examine race-specific health outcomes.

Original languageEnglish (US)
Article number170220
JournalPreventing Chronic Disease
Issue number2
StatePublished - Feb 1 2018
Externally publishedYes

Bibliographical note

Funding Information:
Funding for this project was provided by CDC through the Racial and Ethnic Approaches to Community Health Program and grant no. 1U58DP00594. The census-tract-level mortality data used in this analysis and Dr Baltrus and Mr Xu are partially funded by a grant from the American Heart Association's Strategically Focused Research Network in Health Disparities (Morehouse-Emory Cardiovascular Study, no. 15SFDRNh26140001). Dr Baltrus was also supported by Deep South Resource Center for Minority Aging Research ([National Institute on Aging]: P30AG031054) from the National Institutes of Health (NIH). Drs Rollins and Henry Akintobi are supported through research infrastructure grants, including CDC's Health Promotion and Disease Prevention Research Center, grant no. 1U58DP005946; the National Institutes on Minority Health and Health Disparities, grant no. S21MD000101; and the National Institute of Diabetes and Digestive and Kidney Diseases, grant no. P30DK111024. The content of this article is solely the responsibility of the authors and does not necessarily represent the official views of the National Institute on Aging, CDC, or NIH.


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