학술논문

Association between neighborhood social cohesion, awareness of chronic diseases, and participation in healthy behaviors in a community cohort
Document Type
article
Source
BMC Public Health. 21(1)
Subject
Epidemiology
Public Health
Health Sciences
Aging
Cardiovascular
Kidney Disease
Prevention
Clinical Research
Behavioral and Social Science
Metabolic and endocrine
Good Health and Well Being
Black or African American
Chronic Disease
Cooperative Behavior
Health Behavior
Humans
Middle Aged
Residence Characteristics
Social cohesion
Kidney disease
CKD awareness
CKD
HANDLS
Healthy behaviors
Health disparities
Public Health and Health Services
Health services and systems
Public health
Language
Abstract
BackgroundNeighborhood social cohesion (NSC) is the network of relationships as well as the shared values and norms of residents in a neighborhood. Higher NSC has been associated with improved cardiovascular health, largely among Whites but not African Americans. In a bi-racial cohort, we aimed to study the association between NSC and chronic disease awareness and engagement in healthy self-management behaviors, two potential mechanisms by which NSC could impact cardiovascular health outcomes.MethodsUsing the Healthy Aging in Neighborhoods of Diversity Across the Lifespan Study (HANDLS), we cross-sectionally examined the association between NSC and awareness of three chronic conditions (diabetes, chronic kidney disease (CKD), and hypertension) and engagement in healthy self-management behaviors including physical activity, healthy eating, and cigarette avoidance.ResultsStudy participants (n = 2082) had a mean age of 56.5 years; 38.7% were White and 61.4% African American. Of the participants, 26% had diabetes, 70% had hypertension and 20.2% had CKD. Mean NSC was 3.3 (SD = 0.80) on a scale of 1 (lowest score) to 5 (highest score). There was no significant association between NSC and any chronic disease awareness, overall or by race. However, each higher point in mean NSC score was associated with less cigarette use and healthier eating scores, among Whites (adjusted odds ratio [aOR], 95% confidence interval [CI]: =0.76, 0.61-0.94; beta coefficient [βc]:, 95% CI: 1.75; 0.55-2.97, respectively) but not African Americans (aOR = 0.95, 0.79-1.13; βc: 0.46, - 0.48-1.39, respectively; Pinteraction = 0.08 and 0.06). Among both Whites and African Americans, higher NSC scores were associated with increases in self-reported physical activity (βc: 0.12; 0.08-0.16; Pinteraction = 0.40).ConclusionsCommunity engagement and neighborhood social cohesion may be important targets for promotion of healthy behaviors and cardiovascular disease prevention. More research is needed to understand the different associations of NSC and healthy behaviors by race.