Cardiovascular
Neighborhood Physical Disorder and Stroke: Findings from the Health and Retirement Study Mohammad Moniruzzaman* Mohammad Moniruzzaman Yangyang Deng Breanna Rogers Ram Jagannathan Lu Hu Kosuke Tamura
PURPOSE: Stroke is the fifth leading cause of death in the United States. Neighborhood physical disorder may contribute to an elevated risk of stroke; however, this relationship remains understudied. We investigated whether higher levels of neighborhood physical disorder are associated with an increased risk of stroke and examined potential variations by age, sex, and race.
METHODS: Data came from the 2022 Health and Retirement Study, the most recent available data (n=3754; females=54.1%; mean age=69.1 years; non-White adults=15.4%). Stroke status was assessed by self-reported physician diagnosis (yes/no). Perceived neighborhood physical disorder was assessed using a scale measuring physical features of neighborhoods (e.g., vandalism, vacant houses); higher scores indicate greater physical disorder and were expressed as a 1-SD increase. Weighted generalized logistic regression was used to evaluate the association between neighborhood physical disorder and stroke, adjusted for age, sex, race, marital status, education, employment, smoking, alcohol drinking, and hypertension. Analyses were stratified by sex (male, female), age groups (<69, ≥69 years), and racial groups (White, non-White).
RESULTS: Stroke occurred in 251 participants. Each 1 SD increase in neighborhood physical disorder was significantly associated with 27% higher odds of stroke in the overall sample (OR: 1.27, 95% CI 1.06–1.51), 38% higher odds in females (OR:1.38, 95% CI 1.12–1.69), and 30% higher odds in White adults (OR:1.30, 95% CI 1.05–1.61). No significant association was observed among males, non-White adults, or across age groups.
CONCLUSION: Higher neighborhood physical disorder was associated with an increased risk of stroke, particularly among females and White adults. Targeting specific aspects of neighborhood physical disorder may mitigate stroke risk and reduce disparities. Future research is needed to further explore the observed differences and mechanisms underlying these relationships.
Keywords: physical disorder, neighborhood environment, stroke, adults, disparities