Longitudinal associations of neighborhood socioeconomic status with cardiovascular risk factors: A 46-year follow-up study

Objectives: Neighborhood characteristics are increasingly recognized as important determinants of cardiovascular disease (CVD) risk. However, longitudinal studies on the health impacts of neighborhood characteristics are rare. We sought to investigate whether neighborhood socioeconomic status (NSES) during birth, childhood and adulthood is associated with CVD risk factors in adulthood.

Methods: Using longitudinal data from the New England Family Study (n = 671) with 46-years of follow-up, participants' home addresses were geocoded at birth (mean age = 1.6 months), childhood (mean age = 7.1 years), and adulthood (mean age = 44.2 years) across Massachusetts and Rhode Island in the US from 1961 to 2007. We used multilevel models to evaluate associations of NSES across the life-course with systolic blood pressure, diastolic blood pressure and body mass index (BMI) in adulthood, adjusting for age, sex, race/ethnicity, mother's race, individual SES, and parental SES.

Results: In fully adjusted models, one standard deviation higher NSES at birth was associated with a 1.9 mmHg lower SBP (95% CI: 3.8, -0.1) and 1.3 mmHg lower DBP (95%CI: 2.6,-0.03) in adulthood; while one standard deviation of higher NSES at adulthood was associated with 0.87 kg/m2 lower BMI (95%CI: 1.7, -0.1).

Conclusions: We found that living in a socioeconomically disadvantaged neighborhood early in life and in adulthood was associated with blood pressure and BMI, respectively, two established risk factors for CVD. Our findings support a longitudinal association between exposure to socioeconomically disadvantaged neighborhoods in early life and CVD risk factors in adulthood.