Neighborhood Racial Diversity and Metabolic Syndrome: 2003–2008 National Health and Nutrition Examination Survey

Original Paper
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Abstract

This study investigated the independent association between neighborhood racial/ethnic diversity and metabolic syndrome among US adults, and focused on how this association differed across individual and neighborhood characteristics (i.e., race/ethnicity, sex, age, urbanity, neighborhood poverty). Objectively-measured biomarker data from 2003 to 2008 National Health and Nutrition Examination Survey were linked to census-tract profiles from 2000 decennial census (N = 10,122). Multilevel random intercept logistic regression models were estimated to examine the contextual effects of tract-level racial/ethnic diversity on individual risks of metabolic syndrome. Overall, more than 20% of the study population were identified as having metabolic syndrome, although the prevalence also varied across demographic subgroups and specific biomarkers. Multilevel analyses showed that increased racial/ethnic diversity within a census tract was associated with decreased likelihood of having metabolic syndrome (OR 0.71, 95% CI 0.52–0.96), particularly among female (OR 0.64; 95% CI 0.43–0.96), young adults (OR 0.60; 95% CI 0.39–0.93), and residents living in urban (OR 0.67; 95% CI 0.48–0.93) or poverty neighborhoods (OR 0.54; 95% CI 0.31–0.95). The findings point to the potential benefits of neighborhood racial/ethnic diversity on individual health risks.

Keywords

Health disparities Neighborhoods Race Ethnicity Biomarkers Metabolic syndrome 

Notes

Acknowledgements

This study was funded by the National Institute of General Medical Sciences of the National Institutes of Health (R01CA140319-01A1; PI: Wen). Li also acknowledged a faculty summer grant from the College of Natural and Behavioral Sciences supported by K. T. and E. L. Norris Foundation.

References

  1. 1.
    National Heart, Lung and Blood Institute. What is metabolic syndrome? Retrieved August 21, 2017 from http://www.nhlbi.nih.gov/health/health-topics/topics/ms.
  2. 2.
    Grundy SM, Cleeman JI, Daniels SR, Donato K, Eckel RH, Franklin B, a, et al. Diagnosis and management of the metabolic syndrome: an American Heart Association/National Heart, Lung, and Blood Institute Scientific Statement. Circulation 2005;112:2735–52.CrossRefPubMedGoogle Scholar
  3. 3.
    Mozumdar A, Liguori G. Persistent increase of prevalence of metabolic syndrome among U.S. adults: NHANES III to NHANES 1999–2006. Diabetes Care 2011;34:216–9.CrossRefPubMedGoogle Scholar
  4. 4.
    Karlamangla AS, Merkin SS, Crimmins EM, Seeman TE. Socioeconomic and ethnic disparities in cardiovascular risk in the United States, 2001–2006. Ann Epidemiol. 2010;20:617–28.CrossRefPubMedCentralPubMedGoogle Scholar
  5. 5.
    Williams DR, Collins C. Racial residential segregation: a fundamental cause of racial disparities in health. Public Health Rep. 2001;116:404–16.CrossRefPubMedCentralPubMedGoogle Scholar
  6. 6.
    Bellatorre A, Finch BK, Do DP, Bird CE, Beck AN. Contextual predictors of cumulative biological risk: segregation and allostatic load. Soc Sci Q. 2011;92:1338–62.Google Scholar
  7. 7.
    Jones A. Segregation and cardiovascular illness: the role of individual and metropolitan socioeconomic status. Health Place 2013;22:56–67.CrossRefPubMedGoogle Scholar
  8. 8.
    Li K, Wen M, Henry KA. Ethnic density, immigrant enclaves, and Latino health risks: a propensity score matching approach. Soc Sci Med. 2017;189:44–52.CrossRefPubMedGoogle Scholar
  9. 9.
    Liao FH, Farber S, Ewing R. Compact development and preference heterogeneity in residential location choice behaviour: a latent class analysis. Urban Stud. 2014;52:1–24.Google Scholar
  10. 10.
    Durand CP, Andalib M, Dunton GF, Wolch J, Pentz MA. A systematic review of built environment factors related to physical activity and obesity risk: implications for smart growth urban planning. Obes Rev. 2011;12:e173-82.CrossRefPubMedGoogle Scholar
  11. 11.
    Osypuk TL, Roux AV, Hadley C, Kandula NR. Are immigrant enclaves healthy places to live? The multi-ethnic study of atherosclerosis. Soc Sci Med. 2009;69:110–20.CrossRefPubMedCentralPubMedGoogle Scholar
  12. 12.
    Yi SS, Ruff RR, Jung M, Waddell EN. Racial/ethnic residential segregation, neighborhood poverty and urinary biomarkers of diet in New York City adults. Soc Sci Med. 2014;122:122–9.CrossRefPubMedGoogle Scholar
  13. 13.
    Macintyre S, Ellaway A, Cummins S. Place effects on health: how can we conceptualise, operationalise and measure them? Soc Sci Med. 2002;55:125–39.CrossRefPubMedGoogle Scholar
  14. 14.
    Wen M, Kowaleski-Jones L. The built environment and risk of obesity in the United States: racial-ethnic disparities. Health Place 2012;18:1314–22.CrossRefPubMedCentralPubMedGoogle Scholar
  15. 15.
    Wen M, Maloney TN. Latino residential isolation and the risk of obesity in Utah: the role of neighborhood socioeconomic, built-environmental, and subcultural context. J Immigr Minor Health. 2011;13:1134–41.CrossRefPubMedCentralPubMedGoogle Scholar
  16. 16.
    Bécares L, Nazroo J, Stafford M. The buffering effects of ethnic density on experienced racism and health. Health Place 2009;15:670–8.CrossRefPubMedGoogle Scholar
  17. 17.
    Diez Roux AV, Mair C. Neighborhoods and health. Ann NY Acad Sci. 2010;1186:125–45.CrossRefPubMedGoogle Scholar
  18. 18.
    Sharkey P, Faber JW. Where. When, why, and for whom do residential contexts matter? Moving away from the dichotomous understanding of neighborhood effects. Annu Rev Sociol. 2013;40:559–79.CrossRefGoogle Scholar
  19. 19.
    Kershaw KN, Albrecht SS, Carnethon MR. Racial and ethnic residential segregation, the neighborhood socioeconomic environment, and obesity among blacks and Mexican Americans. Am J Epidemiol. 2013;177:299–309.CrossRefPubMedCentralPubMedGoogle Scholar
  20. 20.
    Chang VW, Hillier AE, Mehta NK. Neighborhood racial isolation, disorder and obesity. Soc Forces. 2009;87:2063–92.CrossRefPubMedCentralPubMedGoogle Scholar
  21. 21.
    Li K, Wen M, Henry KA. Residential racial composition and black-white obesity risks: differential effects of neighborhood social and built environment. Int J Environ Res Public Health. 2014;11:626–42.CrossRefPubMedCentralPubMedGoogle Scholar
  22. 22.
    Roy AL, Hughes D, Yoshikawa H. Exploring neighborhood effects on health and life satisfaction: disentangling neighborhood racial density and neighborhood income. Race Soc Probl. 2012;4:193–204.CrossRefGoogle Scholar
  23. 23.
    Salinas JJ, Rocha E, Abdelbary BE, Gay J, Sexton K. Impact of Hispanic ethnic concentration and socioeconomic status on obesity prevalence in Texas counties. Int J Environ Res Public Health. 2012;9:1201–15.CrossRefPubMedCentralPubMedGoogle Scholar
  24. 24.
    Massey DS, Denton NA. American apartheid: segregation and the making of the underclass. Harvard: Harvard University Press; 1993.Google Scholar
  25. 25.
    Quillian L. Segregation and poverty concentration: the role of three segregations. Am Sociol Rev. 2012;77:354–79.CrossRefPubMedCentralPubMedGoogle Scholar
  26. 26.
    Frey WH, Farley R. Latino, Asian, and Black segregation in U.S. metropolitan areas: are multiethnic metros different? Demography 1996;33:35–50.CrossRefPubMedGoogle Scholar
  27. 27.
    Lichter DT. Immigration and the new racial diversity in rural America. Rural Sociol. 2012;77:3–35.CrossRefPubMedCentralPubMedGoogle Scholar
  28. 28.
    Krieger N, Feldman JM, Waterman PD, Chen JT, Coull BA, Hemenway D. Local residential segregation matters: stronger association of census tract compared to conventional city-level measures with fatal and non-fatal assaults (total and firearm related), using the index of concentration at the extremes (ICE) for racial, economic, and racialized economic segregation, Massachusetts (US), 1995–2010. J Urban Health. 2017;94:244–58.CrossRefPubMedGoogle Scholar
  29. 29.
    Wilkinson RG, Pickett KE. Income inequality and population health: a review and explanation of the evidence. Soc Sci Med. 2006;62:1768–84.CrossRefPubMedGoogle Scholar
  30. 30.
    Walton E. Residential segregation and birth weight among racial and ethnic minorities in the United States. J Health Soc Behav. 2009;50:427–42.CrossRefPubMedGoogle Scholar
  31. 31.
    Kershaw KN, Diez Roux AV, Burgard SA, Lisabeth LD, Mujahid MS, Schulz AJ. Metropolitan-level racial residential segregation and black-white disparities in hypertension. Am J Epidemiol. 2011;174:537–45.CrossRefPubMedCentralPubMedGoogle Scholar
  32. 32.
    Chaix B, Bean K, Leal C, Thomas F, Havard S, Evans D, et al. Individual/neighborhood social factors and blood pressure in the RECORD Cohort Study: which risk factors explain the associations? Hypertension 2010;55:769–75.CrossRefPubMedGoogle Scholar
  33. 33.
    U.S. Census Bureau. Statistical brief: poverty areas. Retrieved August 21, 2017 from https://www.census.gov/population/socdemo/statbriefs/povarea.html.
  34. 34.
    U.S. Department of Agriculture. Rural-Urban Commuting Area Codes (2013). Retrieved August 21, 2017 from http://www.ers.usda.gov/data-products/rural-urban-commuting-area-codes.aspx
  35. 35.
    Crimmins EM, Kim JK, Alley DE, Karlamangla A, Seeman T. Hispanic paradox in biological risk profiles. Am J Public Health Am Public Health Assoc. 2007;97:1305–10.CrossRefGoogle Scholar
  36. 36.
    Raudenbush SW, Bryk AS. Hierarchical linear models: applications and data analysis methods. 2nd ed. Thousand Oaks: Sage Publications; 2002.Google Scholar
  37. 37.
    Sampson RJ. Disparity and diversity in the contemporary city: social (dis)order revisited. Br J Sociol. 2009;60:1–31.CrossRefPubMedCentralPubMedGoogle Scholar
  38. 38.
    Ishizawa H, Jones A. Immigrant neighborhood concentration, acculturation and obesity among young adults. J Urban Aff. 2016;38:298–311.CrossRefGoogle Scholar
  39. 39.
    Robert SA, Li LW. Age variation in the relationship between community socioeconomic status and adult health. Res Aging. 2001;23:234–59.CrossRefGoogle Scholar
  40. 40.
    Dowd JB, Zajacova A, Aiello AE. Predictors of inflammation in U.S. children aged 3–16 years. Am J Prev Med. 2010;39:314–20.CrossRefPubMedCentralPubMedGoogle Scholar
  41. 41.
    Rainisch BKW, Upchurch DM. Sociodemographic correlates of allostatic load among a national sample of adolescents: findings from the National Health and Nutrition Examination Survey, 1999–2008. J Adolesc Heal. 2013;53:506–11.CrossRefGoogle Scholar
  42. 42.
    Theall KP, Drury SS, Shirtcliff EA. Cumulative neighborhood risk of psychosocial stress and allostatic load in adolescents. Am J Epidemiol. 2012;176:S164–74.CrossRefPubMedCentralPubMedGoogle Scholar

Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature 2018

Authors and Affiliations

  1. 1.Department of SociologyCalifornia State University-Dominguez HillsCarsonUSA
  2. 2.Department of SociologyUniversity of UtahSalt Lake CityUSA
  3. 3.Department of Family and Consumer StudiesUniversity of UtahSalt Lake CityUSA

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