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Toms Augustin, MD, MPH, Thomas A. Glass, PhD, Bryan D. James, MBE and Brian S. Schwartz, MD

At the time of the study, Toms Augustin and Bryan D. James were with the Center on Aging and Health, Johns Hopkins University, Baltimore, MD. Thomas A. Glass, Bryan D. James, and Brian S. Schwartz were with the Department of Epidemiology, Johns Hopkins University, Baltimore. Brian S. Schwartz was with the Department of Environmental Health Sciences, Bloomberg School of Public Health, Johns Hopkins University, Baltimore.

Correspondence: Requests for reprints should be sent to Thomas A. Glass, Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, 615 N Wolfe St, Baltimore, MD 21205 (e-mail: tglass{at}jhsph.edu).

Objectives. We examined associations between cardiovascular disease and neighborhood psychosocial hazards, such as violent crime, abandoned buildings, and signs of incivility, to evaluate whether features of place are associated with older adult health.

Methods. We analyzed first-visit data from the Baltimore Memory Study of randomly selected residents aged 50 to 70 years (n=1140) of 65 contiguous neighborhoods in Baltimore, Maryland. We looked for associations between self-reports of history of selected cardiovascular diseases and scores on the 12-item neighborhood psychosocial hazards scale.

Results. After adjustment for established individual risk factors for cardiovascular disease, residents in neighborhoods with scores in the highest quartile of the psychosocial hazards scale had more than 4 times higher odds of a history of myocardial infarction and more than 3 times higher odds of myocardial infarction, stroke, transient ischemic attack, or intermittent claudication compared with residents living in neighborhoods scoring in the lowest quartile.

Conclusions. Neighborhood psychosocial hazards were significantly associated with self-reported cardiovascular disease after adjustment for individual-level risk factors. This is consistent with the hypothesis that environmental stress plays a role in the etiology of cardiovascular disease.

This article has been cited by other articles:

				T. A. Glass, K. Bandeen-Roche, M. McAtee, K. Bolla, A. C. Todd, and B. S. Schwartz Neighborhood Psychosocial Hazards and the Association of Cumulative Lead Dose With Cognitive Function in Older Adults Am. J. Epidemiol., March 15, 2009; 169(6): 683 - 692. [Abstract] [Full Text] [PDF]