Association of Environmental Injustice and Cardiovascular Diseases and Risk Factors in the United States.

Journal: Journal of the American Heart Association

Volume: 13

Issue: 7

Year of Publication: 

Affiliated Institutions:  Division of Cardiovascular Medicine, Department of Medicine Lahey Hospital & Medical Center Burlington MA USA. Department of Medicine, Cleveland Clinic Akron General Akron OH USA. Division of Cardiovascular Prevention and Wellness, Houston Methodist DeBakey Heart and Vascular Center Houston TX USA. Harrington Heart and Vascular Institute, University Hospitals and Case Western Reserve School of Medicine Cleveland OH USA. Department of Environmental Health Harvard T.H. Chan, School of Public Health Boston MA USA. Cardiovascular Division Brigham and Women's Hospital Boston MA USA.

Abstract summary 

While the impacts of social and environmental exposure on cardiovascular risks are often reported individually, the combined effect is poorly understood.Using the 2022 Environmental Justice Index, socio-environmental justice index and environmental burden module ranks of census tracts were divided into quartiles (quartile 1, the least vulnerable census tracts; quartile 4, the most vulnerable census tracts). Age-adjusted rate ratios (RRs) of coronary artery disease, strokes, and various health measures reported in the Prevention Population-Level Analysis and Community Estimates data were compared between quartiles using multivariable Poisson regression. The quartile 4 Environmental Justice Index was associated with a higher rate of coronary artery disease (RR, 1.684 [95% CI, 1.660-1.708]) and stroke (RR, 2.112 [95% CI, 2.078-2.147]) compared with the quartile 1 Environmental Justice Index. Similarly, coronary artery disease 1.057 [95% CI,1.043-1.0716] and stroke (RR, 1.118 [95% CI, 1.102-1.135]) were significantly higher in the quartile 4 than in the quartile 1 environmental burden module. Similar results were observed for chronic kidney disease, hypertension, diabetes, obesity, high cholesterol, lack of health insurance, sleep <7 hours per night, no leisure time physical activity, and impaired mental and physical health >14 days.The prevalence of CVD and its risk factors is highly associated with increased social and environmental adversities, and environmental exposure plays an important role independent of social factors.

Authors & Co-authors:  Khadke Kumar Al-Kindi Rajagopalan Kong Nasir Ahmad Adamkiewicz Delaney Nohria Dani Ganatra

Study Outcome 

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Statistics
Citations : 
Authors :  12
Identifiers
Doi : 10.1161/JAHA.123.033428
SSN : 2047-9980
Study Population
Male,Female
Mesh Terms
Other Terms
cardiometabolic outcomes;environmental burden;environmental justice index;social determinants of health;social vulnerability
Study Design
Study Approach
Country of Study
Publication Country
England