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Neighborhood Environment and Cardiometabolic Disease in Individuals Aging With Physical Disability

The environment may be particularly important for facilitating participation and health for individuals aging with physical disability. However, little is known about which features of the neighborhood are particularly pertinent for this population. This study aims to address this gap by examining t...

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Autores principales: Khan, Anam, Lin, Paul, Kamdar, Neil, Mahmoudi, Elham, Clarke, Philippa
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Oxford University Press 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8680506/
http://dx.doi.org/10.1093/geroni/igab046.1837
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author Khan, Anam
Lin, Paul
Kamdar, Neil
Mahmoudi, Elham
Clarke, Philippa
author_facet Khan, Anam
Lin, Paul
Kamdar, Neil
Mahmoudi, Elham
Clarke, Philippa
author_sort Khan, Anam
collection PubMed
description The environment may be particularly important for facilitating participation and health for individuals aging with physical disability. However, little is known about which features of the neighborhood are particularly pertinent for this population. This study aims to address this gap by examining the type(s) of neighborhood environments associated with cardiometabolic disease. We identified ~26,000 individuals with a diagnosis of physical disability using a national private health insurance claims database in the U.S. Geocoded information for individuals was used to assign them to features of their neighborhood from the National Neighborhood Data Archive. An adapted typology was used to classify neighborhoods into the following based on density of health-promoting and harming features: 1) High health-promoting/harming (service-dense), 2) High health-promoting/low harming, 3) Low health-promoting/high harming, 4) Low health-promoting/harming, and 5) Average. We used time-varying Cox models to estimate adjusted hazard ratios (HR) and 95% confidence intervals (CI) for time-to incident cardiometabolic conditions. High neighborhood-level affluence, and low disadvantage scores characterized service-dense neighborhoods. They had more than 2x higher density of health-promoting resources (e.g., transit) compared to other neighborhood types. Individuals residing in service-dense neighborhoods had an 8% lower risk of any cardiometabolic disease (HR 0.92, 95% CI: 0.85-0.99) compared to those in average neighborhoods. Similar effects were observed for Hypertension and Type 2 Diabetes, with effects most pronounced for the latter (HR 0.82, 95% CI: 0.71-0.94). For individuals aging with physical disabilities, service-dense neighborhoods may be protective against cardiometabolic morbidity. Findings can inform community design that support cardiometabolic health in this population.
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spelling pubmed-86805062021-12-17 Neighborhood Environment and Cardiometabolic Disease in Individuals Aging With Physical Disability Khan, Anam Lin, Paul Kamdar, Neil Mahmoudi, Elham Clarke, Philippa Innov Aging Abstracts The environment may be particularly important for facilitating participation and health for individuals aging with physical disability. However, little is known about which features of the neighborhood are particularly pertinent for this population. This study aims to address this gap by examining the type(s) of neighborhood environments associated with cardiometabolic disease. We identified ~26,000 individuals with a diagnosis of physical disability using a national private health insurance claims database in the U.S. Geocoded information for individuals was used to assign them to features of their neighborhood from the National Neighborhood Data Archive. An adapted typology was used to classify neighborhoods into the following based on density of health-promoting and harming features: 1) High health-promoting/harming (service-dense), 2) High health-promoting/low harming, 3) Low health-promoting/high harming, 4) Low health-promoting/harming, and 5) Average. We used time-varying Cox models to estimate adjusted hazard ratios (HR) and 95% confidence intervals (CI) for time-to incident cardiometabolic conditions. High neighborhood-level affluence, and low disadvantage scores characterized service-dense neighborhoods. They had more than 2x higher density of health-promoting resources (e.g., transit) compared to other neighborhood types. Individuals residing in service-dense neighborhoods had an 8% lower risk of any cardiometabolic disease (HR 0.92, 95% CI: 0.85-0.99) compared to those in average neighborhoods. Similar effects were observed for Hypertension and Type 2 Diabetes, with effects most pronounced for the latter (HR 0.82, 95% CI: 0.71-0.94). For individuals aging with physical disabilities, service-dense neighborhoods may be protective against cardiometabolic morbidity. Findings can inform community design that support cardiometabolic health in this population. Oxford University Press 2021-12-17 /pmc/articles/PMC8680506/ http://dx.doi.org/10.1093/geroni/igab046.1837 Text en © The Author(s) 2021. Published by Oxford University Press on behalf of The Gerontological Society of America. https://creativecommons.org/licenses/by/4.0/This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) ), which permits unrestricted reuse, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Abstracts
Khan, Anam
Lin, Paul
Kamdar, Neil
Mahmoudi, Elham
Clarke, Philippa
Neighborhood Environment and Cardiometabolic Disease in Individuals Aging With Physical Disability
title Neighborhood Environment and Cardiometabolic Disease in Individuals Aging With Physical Disability
title_full Neighborhood Environment and Cardiometabolic Disease in Individuals Aging With Physical Disability
title_fullStr Neighborhood Environment and Cardiometabolic Disease in Individuals Aging With Physical Disability
title_full_unstemmed Neighborhood Environment and Cardiometabolic Disease in Individuals Aging With Physical Disability
title_short Neighborhood Environment and Cardiometabolic Disease in Individuals Aging With Physical Disability
title_sort neighborhood environment and cardiometabolic disease in individuals aging with physical disability
topic Abstracts
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8680506/
http://dx.doi.org/10.1093/geroni/igab046.1837
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