Abstract WP193: Neighborhood-level Ethnic And Racial Segregation And Incident Stroke Risk

Autor: Adam de Havenon, Aaron Bangad, Mehdi Abbasi, Richa Sharma, Kevin N Sheth, Lesli Skolarus
Rok vydání: 2023
Předmět:
Zdroj: Stroke. 54
ISSN: 1524-4628
0039-2499
DOI: 10.1161/str.54.suppl_1.wp193
Popis: Background: Neighborhood-level ethnic and racial segregation has been linked to health status. We explored whether community level segregation is associated with incident stroke. Methods: We used data from Multi-Ethnic Study of Atherosclerosis (MESA). The exposure was neighborhood racial/ethnic segregation measured separately for self-identified White, Black and Hispanic participants and calculated as the Getis-Ord Gi* statistic based on the geocoded address of the participant. The Gi* statistic was categorized using the validated cut points of low, medium, and high neighborhood racial/ethnic segregation (high segregation means that the participant’s neighborhood primarily contained individuals of their race/ethnicity). The primary outcome was incident stroke (ischemic and hemorrhagic) during follow-up. We fit time-to-event Cox models with an interaction between race*segregation and adjustment for age, sex, hypertension, diabetes, hyperlipidemia, and current smoking. The results were further evaluated using marginal effects after logistic regression. Results: We included 5,411 MESA participants (mean age 62.0±10.1, 47.4% male, 44.4% White, 31.0% Black, 24.6% Hispanic), of which 111 (2.1%) had incident stroke during 8.0±1.3 years of follow-up. In the low, medium, and high neighborhood segregation categories there were 1,603 (29.6%), 1,667 (30.8%), and 2,141 (39.6%) individuals. High neighborhood segregation was more common in Black (45.7%) and Hispanic (39.7%) individuals than White (14.6%) (p Conclusions: For White individuals, a high level of segregation is associated with a lower probability of stroke, but for Black individuals with a higher probability of stroke. These findings call for further research into the mechanisms by which neighborhood segregation may mediate stroke risk.
Databáze: OpenAIRE
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