Abstract T P131: Residential Ethnic Segregation and Stroke Risk in Mexican Americans in the BASIC Project
Background: Neighborhoods with high racial-ethnic segregation may have weak community cohesion, low neighborhood trust, and high levels of stress which may impact stroke risk factors such as hypertension. We tested the hypothesis that greater residential ethnic segregation is associated with higher stroke risk in a bi-ethnic community.
Methods: Strokes were identified from the BASIC Project in Nueces County, Texas from 2000-2010. Residential ethnic segregation (range: 0-1) was derived for each census tract (used to define neighborhoods) in the county based on 2000 census data. The measure reflects the probability that a Mexican American (MA) shares their neighborhood with another MA and was categorized into: 1) predominantly non-Hispanic white (NHW, <0.3), 2) ethnically mixed (0.3-0.7), or 3) predominately MA (>0.7). Poisson models were used to examine the association between residential ethnic segregation and stroke risk unadjusted and adjusted for age, sex, ethnicity and neighborhood income. Effect modification by ethnicity was examined in the fully adjusted model, and models were run stratified by ethnicity.
Results: A total of 2,857 strokes were included. Median residential ethnic segregation was 0.52 (IQR: 0.38-0.77). In the unadjusted model, predominately MA census tracts had greater stroke risk than predominantly NHW census tracts [ethnically mixed: RR=1.23 (95% CI: 1.12-1.35); predominately MA: RR=1.67 (95% CI: 1.51-1.83)]. After adjustment, residential ethnic segregation was not associated with stroke risk [ethnically mixed: RR=1.00 (95% CI: 0.71-1.42); predominately MA: RR=1.11(95% CI: 0.76-1.61)]. Effect modification by ethnicity was not significant (p=0.37), but in the stratified model limited to MAs, predominately MA census tracts had a trend toward higher stroke risk compared to MAs living in predominately NHW census tracts [RR=1.41 (95% CI: 0.94-2.12)] after adjustment for demographics and neighborhood income.
Conclusions: Stroke risk for MAs was greater in neighborhoods with high ethnic segregation than in predominantly NHW neighborhoods suggesting that features of highly segregated neighborhoods may contribute to elevated stroke risk in MAs.
Author Disclosures: R.C. Patel: None. M.A. Smith: None. L.B. Morgenstern: Research Grant; Modest; St. Jude Medical. L.D. Lisabeth: None.
- © 2014 by American Heart Association, Inc.