ArticleAmerican journal of epidemiology2018
Unequal Exposure or Unequal Vulnerability? Contributions of Neighborhood Conditions and Cardiovascular Risk Factors to Socioeconomic Inequality in Incident Cardiovascular Disease in the Multi-Ethnic Study of Atherosclerosis.
Article in American journal of epidemiology, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 24 papers, 1 of them a synthesis that pooled it.
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Who cites it
24 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Multilevel resilience resources and cardiovascular disease in the United States: A systematic review and meta-analysis.Health psychology : official journal of the Division of Health Psychology, American Psychological Association · 2022Pooled it
- Prospective and cross-sectional associations of neighborhood socioeconomic disadvantage with drinking and heavy drinking in mid-adulthood in a US national cohort.Drug and alcohol dependence · 2026Article
- Socioeconomic Disadvantage, John Henryism, and Incident Heart Failure in the Jackson Heart Study.Circulation. Population health and outcomes · 2026Article
- Neighborhood characteristics and incident myocardial infarction in US older adults: evaluation in 2 nationwide cohorts.American journal of epidemiology · 2025Article
- Challenges in the prevention, treatment and management of cardiovascular disease among older adults.The Lancet regional health. Europe · 2025Review
- Complex interaction of waist circumference, cardiometabolic markers, and sex on elderly mortality: a cohort study of 0.4 million UK adults.npj metabolic health and disease · 2025Article
- Accelerated molecular aging in socioeconomically disadvantaged neighborhoods: A racial/ethnic comparison.Health & place · 2025Article
- Structural and social determinants of health: The multi-ethnic study of atherosclerosis.PloS one · 2024Article
- Do associations of physical activity and sedentary behaviour with cardiovascular disease and mortality differ across socioeconomic groups? A prospective analysis of device-measured and self-reported UK Biobank data.British journal of sports medicine · 2023Article
- A qualitative crossroads of rhythm and race: Black patients' experiences living with atrial fibrillation.American heart journal plus : cardiology research and practice · 2023Article
- Current practice and recommendations for advancing how human variability and susceptibility are considered in chemical risk assessment.Environmental health : a global access science source · 2023Review
- Article
- Vulnerability to Hypertension Is a Major Determinant of Racial Disparities in Alzheimer's Disease Risk.American journal of hypertension · 2022Article
- Life-Course Neighborhood Socioeconomic Status and Cardiovascular Events in Black and White Adults in the Atherosclerosis Risk in Communities Study.American journal of epidemiology · 2022Article
- Educational Attainment and Lifestyle Risk Factors Associated With All-Cause Mortality in the US.JAMA health forum · 2022Article
- Associations between neighborhood socioeconomic cluster and hypertension, diabetes, myocardial infarction, and coronary artery disease within a cohort of cardiac catheterization patients.American heart journal · 2022Article
- Roles of allostatic load, lifestyle and clinical risk factors in mediating the association between education and coronary heart disease risk in Europe.Journal of epidemiology and community health · 2021Article
- Does a physical activity supportive environment ameliorate or exacerbate socioeconomic inequities in incident coronary heart disease?Journal of epidemiology and community health · 2021Article
- Temporal trends and demographic risk factors for hospital admissions due to carbon monoxide poisoning in England.Preventive medicine · 2020Article
- Longitudinal associations of neighborhood socioeconomic status with cardiovascular risk factors: A 46-year follow-up study.Social science & medicine (1982) · 2019Article
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7 authors.
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Abstract
Risk factors can drive socioeconomic inequalities in cardiovascular disease (CVD) through differential exposure and differential vulnerability. In this paper, we show how econometric decomposition directly enables simultaneous, policy-oriented assessment of these 2 mechanisms. We specifically estimate contributions of neighborhood environment and proximal risk factors to socioeconomic inequality in CVD incidence via these mechanisms. We followed 5,608 participants in the Multi-Ethnic Study of Atherosclerosis (2000-2012) to their first CVD event (median length of follow-up, 12.2 years). We used a summary measure of baseline socioeconomic position (SEP). Covariates included baseline demographics, neighborhood characteristics, and psychosocial, behavioral, and biomedical risk factors. Using Poisson models, we decomposed the difference (inequality) in incidence rates between low- and high-SEP groups into contributions of 1) differences in covariate means (differential exposure) and 2) differences in CVD risk associated with covariates (differential vulnerability). Notwithstanding large uncertainty in neighborhood estimates, our analysis suggested that differential exposure to poorer neighborhood socioeconomic conditions, adverse social environment, diabetes, and hypertension accounted for most of the inequality. Psychosocial and behavioral contributions were negligible. Further, neighborhood SEP, female sex, and white race were more strongly associated with CVD among low-SEP (vs. high-SEP) participants. These differentials in vulnerability also accounted for nontrivial portions of the inequality and could have important implications for intervention.
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