Health

Study: Neigh­bor­hoods play big role in heart health,

The Progress-Index Weekend - - LIFESTYLES - By Amer­i­can Heart As­so­ci­a­tion News

“Lo­ca­tion, lo­ca­tion, lo­ca­tion” isn’t just an old real es­tate cliché. It’s also a ma­jor fac­tor when it comes to heart health, ac­cord­ing to an over­view ar­ti­cle pub­lished in the Amer­i­can Heart As­so­ci­a­tion jour­nal Cir­cu­la­tion.

The ar­ti­cle stud­ied a grow­ing body of lit­er­a­ture on the re­la­tion­ship be­tween neigh­bor­hoods and heart health and “the com­plex web of in­ter-re­lated so­cial, eco­nomic and phys­i­cal fac­tors that ap­pear to in­flu­ence health be­hav­iors and car­dio­vas­cu­lar risk.” The ar­ti­cle con­cluded that “where pa­tients live may be an im­por­tant con­trib­u­tor to the risk of de­vel­op­ing car­dio­vas­cu­lar dis­ease.” “ZIP code mat­ters as much, if not more, than ge­netic code, at least for some peo­ple,” said Dr. Ed­uardo Sanchez, chief med­i­cal of­fi­cer for pre­ven­tion at the Amer­i­can Heart As­so­ci­a­tion.

“Neigh­bor­hood char­ac­ter­is­tics “Be­hav­ior fac­tors like what you make a dif­fer­ence,” he said. eat, how seden­tary you are, and whether you smoke are all af­fected by so­cial fac­tors like the qual­ity of your neigh­bor­hood and the in­come of your neigh­bor­hood … not just the in­come of the in­di­vid­ual.” Where you live “makes it easier or more dif­fi­cult to adopt and es­pe­cially main­tain health be­hav­iors like be­ing phys­i­cally ac­tive, con­sum­ing less calo­ries, or con­sum­ing more fruits and veg­eta­bles,” said Dr. Ana Diez Roux, dean and pro­fes­sor of epi­demi­ol­ogy at Drexel Univer­sity. “The en­vi­ron­ment in­ter­acts with per­sonal char­ac­ter­is­tics and can serve as a fa­cil­i­ta­tor or im­ped­i­ment in sub­tle but very im­por­tant ways.”

One of the big­gest im­ped­i­ments to heart health is an in­abil­ity for peo­ple to walk, bike and ex­er­cise in many lower-in­come neigh­bor­hoods, said Sanchez. “Neigh­bor­hoods where there is some af­flu­ence are more likely to have side­walks, trails, parks, and other ameni­ties that some of us take for granted,” he said. “Lower-in­come neigh­bor­hoods

have char­ac­ter­is­tics that make it harder to be phys­i­cally ac­tive — char­ac­ter­is­tics like heavy traf­fic, poor light­ing, and the higher like­li­hood of loose dogs run­ning around that may keep chil­dren and oth­ers in­doors.” Liv­ing near busy streets can be un­healthy for other rea- sons, said Diez Roux. “Ex­po­sure to heavy traf­fic De­sign­ing a healthy com­mu­nity The Cen­ters for Dis­ease Con­trol and Pre­ven­tion know that be­ing phys­i­cally ac­tive is hard if you do not have ac­cess to side­walks or parks and eat­ing right is hard if healthy foods are not avail­able. Good health starts with where you live, learn, work and play, so the CDC has cre­ated a check­list to help com­mu­ni­ties and their elected of­fi­cials make de­ci­sions about land use that will make every­one hap­pier and health­ier. Find that check­list by vis­it­ing https:// www.cdc.gov/healthy­places/toolkit/ healthy_­com­mu­ni­ty_de­sign_check­list. pdf For more in­for­ma­tion on healthy com­mu­nity de­sign, go to the fol­low­ing web­sites: • Cen­ters for Dis­ease Con­trol and Pre­ven­tion Healthy Places: www.cdc.gov/ healthy­places • LEED-ND and Healthy Neigh­bor­hoods: http://www.cdc.gov/healthy­places/ fact­sheets/LEED-ND_tabloid_Fi­nal.pdf • Phys­i­cal Ac­tiv­ity and Health: http://www.cdc.gov/phys­i­calac­tiv­ity/ every­one/health/in­dex.html • Com­mu­nity Guide to Pre­ven­tive Ser­vices. En­vi­ron­men­tal and Pol­icy Ap­proaches to In­crease Phys­i­cal Ac­tiv­ity: Com­mu­nity–Scale Ur­ban De­sign Land Use Poli­cies: http://www. thecom­mu­ni­tyguide.org/pa/en­vi­ron­men­tal-pol­icy/com­mu­ni­ty­poli­cies.html may also be linked to car­dio­vas­cu­lar health through the ef­fects of air pol­lu­tion,” she said.

The ar­ti­cle pointed out a link be­tween poor heart health and neigh­bor­hoods where peo­ple ex­pe­ri­ence racial seg­re­ga­tion and dis­crim­i­na­tion. “Pre­dom­i­nantly poor and mi­nor­ity neigh­bor­hoods of­ten have so­cial and phys­i­cal en­vi­ron­ments that are not con­ducive to car­dio­vas­cu­lar health … and these dif­fer­ence arise be­cause of eco­nomic fac­tors, dif­fer­ences in power, and struc­tural racism,” said Diez Roux. The dif­fer­ences, she said, “in turn re­in­force res­i­den­tial seg­re­ga­tion, cre­at­ing a vi­cious cy­cle that re­in­forces health dis­par­i­ties.” Sanchez lauded the ar­ti­cle for point­ing out that car­di­olo- gists need to rec­og­nize the role that neigh­bor­hoods may play in their pa­tients’ heart health.

“Con­text mat­ters,” he said. “Un­der­stand­ing the con­text helps the clin­i­cian to think of other op­tions, but also it keeps the clin­i­cian from blam­ing the pa­tient.”

MARK FREISTEDT/GATEHOUSEMEDIA

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