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Prevalence of CVD, Risk Factors Up in Redlined Neighborhoods

In fully adjusted models, associations for increased prevalence of stroke, CKD across HOLC grades A to D remained statistically significant

TUESDAY, July 5, 2022 (HealthDay News) — Neighborhood characteristics are associated with cardiometabolic disease and risk factors, according to a study published in the July 12 issue of the Journal of the American College of Cardiology.

Issam Motairek, M.D., from the Harrington Heart and Vascular Institute at the University Hospitals Cleveland Medical Center, and colleagues examined the link between historical redlining and contemporary cardiometabolic health risk factors and outcomes. The prevalence of cardiometabolic outcomes and risk factors was examined at the census tract level according to the Home Owners’ Loan Corporation (HOLC) grading, which rates U.S. cities based on racial/ethnic composition, housing conditions, and neighborhood environment. A total of 11,178 HOLC-graded census tracts were included and graded as A, B, C, and D (7.1, 19.4, 42.0, and 31.5 percent, respectively). Redlined neighborhoods were defined as D-graded census tracts.

The researchers found that with increasing HOLC grades, there were increases in the percentage of Black and Hispanic individuals. Compared with neighborhoods with worse HOLC grades, neighborhoods with better HOLC grades had higher cholesterol screening and routine health visits. In addition, there was an almost doubling in the prevalence of individuals aged 18 to 64 years lacking insurance from A- through D-graded areas. The prevalence of diabetes, obesity, hypertension, and smoking increased in stepwise increments from HOLC A to D grades. Significant increases in the prevalence of coronary artery disease (CAD), stroke, and chronic kidney disease (CKD) were seen across HOLC grades A through D; in the fully adjusted model, these associations were attenuated for CAD but remained significant for stroke and CKD.

“Redlining not only affects CAD, stroke, and CKD, but increases risk of associated comorbidities and lack of access to appropriate medical care,” the authors write.

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