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J Racial Ethn Health Disparities. 2016 Sep;3(3):444-56. doi: 10.1007/s40615-015-0157-0. Epub 2015 Sep 28.

Neighborhood Disadvantage and Cumulative Biological Risk Among a Socioeconomically Diverse Sample of African American Adults: An Examination in the Jackson Heart Study.

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Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, 677 Huntington Avenue, 7th Floor, Boston, MA, 02115, USA.
Department of Epidemiology and Biostatistics, School of Public Health, Drexel University, Nesbit Hall, 5th Floor; 3215 Market St., Philadelphia, PA, 19104, USA.
University of Mississippi Medical Center, 2500 North State Street, Jackson, MS, 39216-4505, USA.
My Brother's Keeper, Inc., 710 Avignon Drive, Ridgeland, MS, 39157, USA.
Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, 677 Huntington Avenue, 7th Floor, Boston, MA, 02115, USA.



Neighborhoods characterized by disadvantage influence multiple risk factors for chronic disease and are considered potential drivers of racial and ethnic health inequities in the USA. The objective of the present study was to examine the relationship between neighborhood disadvantage and cumulative biological risk (CBR) and the extent to which the association differs by individual income and education among a large, socioeconomically diverse sample of African American adults.


Data from the baseline examination of the Jackson Heart Study (2000-2004) were used for the analyses. The sample consisted of African American adults ages 21-85 with complete, geocoded data on CBR biomarkers and behavioral covariates (n = 4410). Neighborhood disadvantage was measured using a composite score of socioeconomic indicators from the 2000 US Census. Eight biomarkers representing cardiovascular, metabolic, inflammatory, and neuroendocrine systems were used to create a CBR score. We fit two-level linear regression models with random intercepts and included cross-level interaction terms between neighborhood disadvantage and individual socioeconomic status (SES).


Living in a disadvantaged neighborhood was associated with greater CBR after covariate adjustment (B = 0.18, standard error (SE) 0.07, p < 0.05). Interactions showed a weaker association for individuals with ≤high school education but were not statistically significant.


Disadvantaged neighborhoods contribute to poor health among African American adults via cumulative biological risk. Policies directly addressing the socioeconomic conditions of these environments should be considered as viable options to reduce disease risk in this group and mitigate racial/ethnic health inequities.


African Americans; Cumulative biological risk; Health disparities; Neighborhood disadvantage

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