Association of Area Deprivation Index and hypertension, diabetes, dyslipidemia, and obesity: a cross-sectional study of the HABS-HD cohort.




Seyedahmadi, Armin
Vintimilla, Raul
Hall, James
Johnson, Leigh
O'Bryant, Sid


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Background: Heart disease is a leading cause of death globally and the prevalence of cardiovascular disease (CVD) is expected to increase significantly in the United States over the next decade. Previous research has shown that socioeconomic status has a significant impact on CVD prevalence and outcomes, with risk factors for CVD being more prevalent in individuals from low socioeconomic groups. We aimed to investigate the association between neighborhood deprivation and the prevalence of major CVD risk factors (hypertension, diabetes, dyslipidemia, and obesity) in a Mexican American population compared to Non-Hispanic Whites.

Methods: A cross-sectional analysis was conducted to include 1867 subjects. 971 self-identified as Mexican American (MA), and 896 as Non-Hispanic White (NHW). These participants underwent a clinical interview, neuropsychological exam battery, functional examination, MRI of the head, amyloid PET scan, and blood draw for clinical and biomarker analysis. They were also assigned an ADI score based on participants living in the best and worst neighborhoods according to Area Depravation Index (ADI) model.

Results: Sixty percent of the sample was female. MA were significantly younger (mean age 63.37 vs 68.64) and less educated (mean education years 9.69 vs 15.61 than NHW. Additionally, MA had a significantly higher prevalence of HTN, DM, and obesity. Only 12.3% of Non-Hispanic Whites lived in the most deprived neighborhoods (percentile 4), while 57.5% of Mexican Americans lived in the percentile 4 ranking areas (p≤ .05). There was a significant difference between non-Hispanic White participants living in the least deprived neighborhoods compared to participants living in the most deprived neighborhoods for HTN (OR = 2.14, 95% CI [1.31, 3.48]), DM (OR = 3.42; 95% CI [1.67, 7.01]), and obesity (OR = 3.03, 95% CI [1.86 to 4.95]). There was no significant difference in the odds of having dyslipidemia between non-Hispanic Whites living in the ADI quartile 1 when compared to those living in the ADI quartile 4. These results remained significant after adjusting for age, sex, education, and cardiovascular risk factors.

Conclusion: In conclusion, this study found the area deprivation index (ADI) is associated with cardiovascular risk factors such as hypertension, diabetes, dyslipidemia, and obesity. These findings suggest that socioeconomic status may play a role in the prevalence of certain health conditions among different ethnic groups. Further research is needed to understand the underlying mechanisms and to develop interventions that address health disparities among different ethnic populations.