Neighborhood Socioeconomic Status and Cardiometabolic Outcomes in Urban Jamaica: Exploring Novel MeasuresDyer, Harika Petrina (2023) Neighborhood Socioeconomic Status and Cardiometabolic Outcomes in Urban Jamaica: Exploring Novel Measures. Master Essay, University of Pittsburgh.
AbstractIntroduction: Diabetes, hypertension, high cholesterol, and obesity are increasingly prevalent in Afro-Caribbean populations. Much remains unknown about the relationship between these cardiometabolic outcomes and neighborhood socioeconomic status (SES). This study explores associations between neighborhood SES and cardiometabolic outcomes in urban Jamaica. Methods: Data from urban participants (n=833, women 577, men 282) in an ancillary study to the Jamaica Health and Lifestyle Survey 2016-2017 was analyzed to examine associations between neighborhood SES and cardiometabolic outcomes. Median property sales price was obtained from the Jamaica National Land Agency and selected as the primary neighborhood SES measure. Survey-weighted Poisson regression was used to assess prevalence ratios for measured diabetes, hypertension, high cholesterol, and obesity. Neighborhood percentages of educational attainment, dependency ratio, employment, and household state assistance were covariates in adjusted models. Results: Most participants were aged 45 to 64 (34.9%) and had at least a high school education (77.7%). Men were more likely to be adequately physically active (52.4% vs. 42.0%, p=0.003) and current smokers (29.7% vs. 10.8%, p <0.001). More women had hypertension (53.0% vs. 45.6%, p=0.047), high cholesterol (34.3% vs. 21.7%, p<0.001), and obesity (45.7% vs. 19.4%, p<0.001). Survey-weighted regression showed high neighborhood SES was associated with higher prevalence of hypertension (PR=1.33, p=0.044) and high cholesterol (PR=2.46, p<0.001) in fully adjusted models unstratified by sex when compared with low SES. Increased obesity was observed for the middle (PR=1.46, p<0.001) and high (PR=1.60, p<0.001) SES tiers. In stratified analyses, high neighborhood SES was associated with more obesity among women (P=1.32, p=0.015) and high total cholesterol among men (PR=4.70, p=0.005). Mid SES was associated with increased hypertension among men (PR=2.02, p=0.024). Conclusions: Among urban Jamaicans, associations between neighborhood SES and cardiometabolic outcomes appear nonlinear and dependent on sex, individual risk factors, and neighborhood characteristics. Future research incorporating more complex neighborhood SES measures may help elucidate these relationships. Public Health Significance: Adverse cardiometabolic outcomes disproportionately burden Jamaica and other low- and middle-income countries. A better understanding of neighborhood contributors to these outcomes is essential for developing effective interventions. Share
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