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Individual and Neighborhood Stressors, Air Pollution and Cardiovascular Disease

Author

Listed:
  • Marnie F. Hazlehurst

    (Department of Environmental & Occupational Health Sciences and Department of Epidemiology, School of Public Health, University of Washington, Seattle, WA 98195, USA)

  • Paula S. Nurius

    (School of Social Work, University of Washington, Seattle, WA 98195, USA)

  • Anjum Hajat

    (Department of Epidemiology, School of Public Health, University of Washington, Seattle, WA 98195, USA)

Abstract

Psychosocial and environmental stress exposures across the life course have been shown to be relevant in the development of cardiovascular disease (CVD). Assessing more than one stressor from different domains (e.g., individual and neighborhood) and across the life course moves us towards a more integrated picture of how stress affects health and well-being. Furthermore, these individual and neighborhood psychosocial stressors act on biologic pathways, including immune function and inflammatory response, which are also impacted by ubiquitous environmental exposures such as air pollution. The objective of this study is to evaluate the interaction between psychosocial stressors, at both the individual and neighborhood level, and air pollution on CVD. This study used data from the 2009–2011 Behavioral Risk Factor Surveillance System (BRFSS) from Washington State. Adverse childhood experiences (ACEs) measured at the individual level, and neighborhood deprivation index (NDI) measured at the zip code level, were the psychosocial stressors of interest. Exposures to three air pollutants—particulate matter (both PM 2.5 and PM 10 ) and nitrogen dioxide (NO 2 )—were also calculated at the zip code level. Outcome measures included several self-reported CVD-related health conditions. Both multiplicative and additive interaction quantified using the relative excess risk due to interaction (RERI), were evaluated. This study included 32,151 participants in 502 unique zip codes. Multiplicative and positive additive interactions were observed between ACEs and PM 10 for diabetes, in models adjusted for NDI. The prevalence of diabetes was 1.58 (95% CI: 1.40, 1.79) times higher among those with both high ACEs and high PM 10 compared to those with low ACEs and low PM 10 ( p -value = 0.04 for interaction on the multiplicative scale). Interaction was also observed between neighborhood-level stressors (NDI) and air pollution (NO 2 ) for the stroke and diabetes outcomes on both multiplicative and additive scales. Modest interaction was observed between NDI and air pollution, supporting prior literature on the importance of neighborhood-level stressors in cardiovascular health and reinforcing the importance of NDI on air pollution health effects. ACEs may exert health effects through selection into disadvantaged neighborhoods and more work is needed to understand the accumulation of risk in multiple domains across the life course.

Suggested Citation

  • Marnie F. Hazlehurst & Paula S. Nurius & Anjum Hajat, 2018. "Individual and Neighborhood Stressors, Air Pollution and Cardiovascular Disease," IJERPH, MDPI, vol. 15(3), pages 1-18, March.
  • Handle: RePEc:gam:jijerp:v:15:y:2018:i:3:p:472-:d:135281
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    References listed on IDEAS

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    1. Schwartz, J. & Bellinger, D. & Glass, T., 2011. "Exploring potential sources of differential vulnerability and susceptibility in risk from environmental hazards to expand the scope of risk assessment," American Journal of Public Health, American Public Health Association, vol. 101(SUPPL. 1), pages 94-101.
    2. Walsemann, Katrina M. & Goosby, Bridget J. & Farr, Deeonna, 2016. "Life course SES and cardiovascular risk: Heterogeneity across race/ethnicity and gender," Social Science & Medicine, Elsevier, vol. 152(C), pages 147-155.
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    Cited by:

    1. Jamie L. Humphrey & Colleen E. Reid & Ellen J. Kinnee & Laura D. Kubzansky & Lucy F. Robinson & Jane E. Clougherty, 2019. "Putting Co-Exposures on Equal Footing: An Ecological Analysis of Same-Scale Measures of Air Pollution and Social Factors on Cardiovascular Disease in New York City," IJERPH, MDPI, vol. 16(23), pages 1-19, November.
    2. Dylan B. Jackson & Alexander Testa & Krista P. Woodward & Farah Qureshi & Kyle T. Ganson & Jason M. Nagata, 2022. "Adverse Childhood Experiences and Cardiovascular Risk among Young Adults: Findings from the 2019 Behavioral Risk Factor Surveillance System," IJERPH, MDPI, vol. 19(18), pages 1-18, September.

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