Background
Neighbourhoods and CVD risk
Methods
Outcomes
Individual level factors
Social and built environmental factors
Statistical analysis
Results
Descriptive analysis
Outcome 1: MI only | Outcome 2: Any of MI, angina, CHD, CHF, or stroke | ||||
---|---|---|---|---|---|
Entire Cohort No. (% of sample) | No. (row %) | p-value | No. (row %) | p-value | |
Participants
| 2411 (100) | 47 (1.94) | 103 (4.27) | ||
Age
| 0.0354 | <.0001 | |||
25-35 | 529 (21.93) | 6 (1.11) | 6 (1.21) | ||
36-45 | 742 (30.79) | 9 (1.20) | 20 (2.67) | ||
46-55 | 714 (29.63) | 19 (2.68) | 44 (6.16) | ||
56-65 | 426 (17.65) | 13 (3.00) | 33 (7.67) | ||
Gender
| <.0001 | 0.0105 | |||
Women | 1293 (53.64) | 10 (0.75) | 43 (3.29) | ||
Men | 1117 (46.36) | 37(3.31) | 48 (5.40) | ||
Visible Minority Status
| 0.7446 | 0.3990 | |||
1. Yes | 1062 (44.04) | 19 (1.83) | 41 (3.87) | ||
2. No | 1349 (55.96) | 27 (2.02) | 62 (4.57) | ||
Education
| 0.8194 |
<.0001
| |||
1. Less than High School | 95 (3.95) | 1 (1.45) | 13 (14.11) | ||
2. High School Complete | 389 (16.15) | 6 (1.49) | 12 (3.21) | ||
3. Diploma Complete | 686 (28.44) | 16 (2.27) | 29 (4.17) | ||
4. Completed Undergrad and above | 1241 (51.47) | 24 (1.93) | 48 (3.89) |
Intraclass correlation (ICC)
Multilevel logistic regressions
Model 2 | Model 3 | Model 4 | ||||
---|---|---|---|---|---|---|
Model 1‡ + all neighbourhood factors | Model 2 + selected individual factors | Model 3 + BMI and physical activity | ||||
MI only: Odds ratio (95% CI) | Any CVDs: Odds ratio (95% CI) | MI only: Odds ratio (95% CI) | Any CVDs: Odds ratio (95% CI) | MI only: Odds ratio (95% CI) | Any CVDs: Odds ratio (95% CI) | |
Total (n = 2411) |
Neighbourhood level factors
| |||||
Median household income (in $10,000)
|
0.92 (0.85-0.98)*
|
0.96 (0.94-0.98)*
| 0.94 (0.86-1.02) | 0.98 (0.94-1.02) | 1.02 (0.89-1.15) | 1.16 (0.79-1.53) |
Food stores density
| ||||||
Q1 (low) vs. Q4 (high) |
1.60 (1.11-2.10)**
|
1.48 (1.07-1.90)**
|
1.23 (1.02-1.44)*
|
1.12 (1.01-1.23)*
| 1.07 (0.99-1.15) | 1.03 (0.92-1.14) |
Q2 vs. Q4 | 1.51 (0.99-2.02) | 1.39 (0.95-1.83) | 1.24 (0.95-1.53) | 1.04 (0.89-1.19) | 1.04 (0.90-1.18) | 1.02 (0.87-1.17) |
Q3 vs. Q4 | 1.43 (0.92-1.93) | 1.18 (0.82-1.54) | 1.09 (0.91-1.27) | 0.99 (0.80-1.18) | 1.01 (0.89-1.13) | 0.99 (0.78-1.2) |
Fast food density
| ||||||
Q1 (low) vs. Q4 (high) |
0.89 (0.81-0.97)*
|
0.9 (0.83-0.96)*
|
0.95 (0.91-0.98)*
|
0.97 (0.95-0.99)*
| 1.00 (0.94-1.07) | 1.01 (0.93-1.09) |
Q2 vs. Q4 |
0.96 (0.94-0.99)*
| 0.99 (0.90-1.09) | 1.00 (0.93-1.07) | 1.02 (0.96-1.08) | 1.01 (0.84-1.18) | 1.07 (0.87-1.27) |
Q3 vs. Q4 | 1.01 (0.8-1.22) | 1.01 (0.91-1.11) | 1.02 (0.86-1.15) | 1.01 (0.94-1.08) | 1.03 (0.74-1.32) | 1.04 (0.81-1.27) |
Proportion CT Parks and recreational
| ||||||
Q1 (low) vs. Q4 (high) |
1.19 (1.10-1.31)**
| 1.17 (0.31-2.03) |
1.1 (1.02-1.18)*
| 0.98 (0.44-1.52) | 1.05 (0.80-1.30) | 1.03 (0.11-1.95) |
Q2 vs. Q4 |
1.07 (1.01-1.13)*
| 1.13 (0.21-2.05) | 1.02 (0.73-1.31) | 0.99 (0.27-1.71) | 1.09 (0.63-1.55) | 1.15 (0.22-2.08) |
Q3 vs. Q4 | 1.0 (0.89-1.11) | 1.03 (0.53-1.53) | 1.02 (0.84-1.20) | 1.17 (0.46-1.88) | 1.06 (0.72-1.40) | 1.21 (0.47-1.95) |
Violent crimes per capita
| ||||||
Q1 (low) vs. Q4 (high) |
0.85 (0.78-0.92)*
|
0.79 (0.71-0.87)***
|
0.87 (0.76-0.98)*
|
0.80 (0.71-0.89)***
|
0.93 (0.87-0.99)*
|
0.82 (0.72-0.92)**
|
Q2 vs. Q4 |
0.89 (0.82-0.96)*
|
0.84 (0.73-0.95)**
| 0.93 (0.85-1.01) |
0.88 (0.79-0.97)*
| 0.94 (0.79-1.09) | 0.90 (0.78-1.02) |
Q3 vs. Q4 | 0.91 (0.80-1.02) | 0.89 (0.67-1.11) | 0.98 (0.87-1.09) | 0.95 (0.72-1.18) | 1.02 (0.86-1.18) | 1.00 (0.74-1.27) |
Proportion of housing requiring major repairs in CT
| ||||||
Q1 (low) vs. Q4 (high) | 0.79 (0.28-1.30) | 0.66 (0.25-1.07) | 0.90 (0.61-1.19) | 0.97 (0.48-1.46) | 0.94 (0.62-1.10) | 0.99 (0.51-1.47) |
Q2 vs. Q4 | 0.83 (0.42-1.24) | 0.80 (0.45-1.15) | 0.92 (0.48-1.36) | 1.00 (0.47-1.54) | 0.96 (0.51-1.41) | 1.03 (0.54-1.52) |
Q3 vs. Q4 | 0.91 (0.6-1.22) | 0.74 (0.37-1.11) | 0.94 (0.55-1.33) | 1.02 (0.46-1.58) | 0.98 (0.57-1.39) | 1.09 (0.82-1.36) |
Within 100 m of a major road
|
4.07 (2.91-7.56)***
|
2.33 (1.45-3.97)**
|
3.86 (2.39-6.13)***
|
2.01 (1.87-2.55)**
|
3.79 (2.25-5.53)***
|
1.97 (1.67-2.49)**
|
Disturbed by noise at home
1
| ||||||
1. Strongly Agree |
5.21 (1.88-15.78)***
|
3.37 (1.61-6.75)***
|
4.84 (1.69-13.63)**
|
3.25 (1.59-6.19)**
|
4.83 (1.65-13.20)**
|
3.19 (1.55-6.25)**
|
2. Agree | 1.51 (0.82-4.91) | 1.48 (0.84-3.83) | 1.41 (0.67-4.42) | 1.39 (0.41-3.74) | 1.38 (0.55-4.01) | 1.23 (0.47-3.66) |
3. Neither agree or disagree | 1.28 (0.59-3.89) | 1.17 (0.60-3.69) | 1.25 (0.52-3.72) | 1.16 (0.60-3.79) | 1.07 (0.52-3.59) | 1.01 (0.55-3.60) |
4. Disagree | 0.96 (0.48-4.56) | 1.06 (0.25-1.25) | 1.04 (0.19-3.17) | 0.79 (0.26-1.94) | 0.99 (0.40-4.12) | 0.80 (0.33-2.01) |
Individual level factors
| ||||||
Age (in years)
|
1.05 (1.01-1.09)**
|
1.07 (1.04-1.09)***
|
1.04 (1.01-1.08)**
|
1.07 (1.04-1.09)***
| ||
Male
|
4.91 (2.51-9.63)***
|
1.73 (1.15-2.59)**
|
5.29 (2.60-10.76)***
|
1.71 (1.14-2.56)**
| ||
Visible Minority
| 0.61 (0.30-1.25) | 0.86 (0.55-1.36) | 0.48 (0.21-1.06) | 0.75 (0.45-1.23) | ||
Education
2
| ||||||
Less than High School | 1.66 (0.51-5.37) |
3.66 (1.80-7.63)**
| 1.36 (0.29-4.91) |
3.27 (1.56-6.90)**
| ||
High School Complete | 1.07 (0.47-2.47) | 1.27 (0.72-2.25) | 1.07 (0.44-2.61) | 1.26 (0.69-2.28) | ||
Diploma Complete | 1.40 (0.69-2.86) | 1.59 (0.97-2.59) | 1.30 (0.61-2.78) | 1.43 (0.86-2.36) | ||
After tax Family Income (in $10,000)
|
0.89 (0.86-0.92)***
|
0.90 (0.86-0.94)**
|
0.90 (0.84-0.96)**
|
0.91 (0.87-0.95)**
| ||
Smoking
3
| ||||||
Current smoker |
1.89 (1.24-2.54)**
|
1.43 (1.08-1.78)**
|
1.78 (1.21-2.36)**
|
1.34 (1.08-1.60)**
| ||
Former smoker | 1.00 (0.55-1.46) | 0.98 (0.32-1.64) | 0.88 (0.41-1.36) | 0.90 (0.24-1.57) | ||
Alcohol use
4
| ||||||
Heavy alcohol use | 0.76 (0.40-1.45) | 0.86 (0.56-1.32) | 0.76 (0.29-1.23) | 0.86 (0.54-1.18) | ||
Moderate alcohol use | 0.75 (0.35-1.65) | 0.55 (0.31-1.01) | 0.70 (0.23-1.17) | 0.63 (0.2-1.06) | ||
BMI
5
| ||||||
Underweight | 2.27 (0.29-17.89) | 1.83 (0.42-7.95) | ||||
Overweight | 1.80 (0.86-3.80) | 1.45 (0.88-2.39) | ||||
Obese |
2.52 (1.18-5.36)*
|
2.73 (1.69-4.41)***
| ||||
Engage in regular physical activity
| 0.69 (0.38-1.26) | 0.68 (0.45-1.01) | ||||
Variance Partition Coefficient (VPC)
6
| 8.82%*** | 7.31%*** | 6.11%** | 7.19%** | 5.75%** | 6.08%** |
Pseudo-Akaike Information Criterion (AIC)
| 19288.37 | 20147.68 | 14337.77 | 14769.52 | 13699.38 | 14667.89 |