Journal article
Psychosocial Risk and Resilience as Moderators of the Association Between Neighborhood Disadvantage and Incident Cardiovascular Disease Across Ethnoracial Groups: Multi-Ethnic Study of Atherosclerosis, United States, 2000-2019
American journal of public health (1971), v 116(5), pp 711-721
May 2026
PMID: 41950447
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Abstract
To determine whether optimism and anger modify the association between neighborhood disadvantage and incident cardiovascular disease (CVD) and whether these relationships vary by ethnoracial group.
We drew data from 4326 participants in the Multi-Ethnic Study of Atherosclerosis (MESA: 2000-2019), a cohort of US adults aged 45 to 84 years without baseline CVD. We measured neighborhood disadvantage using the Area Deprivation Index. We assessed optimism and anger (reaction and temperament) by self-report. We used multilevel Cox proportional hazards models to estimate hazard ratios for incident CVD over 19 years of follow-up, adjusting for demographic, behavioral, and clinical factors.
A total of 879 incident CVD events occurred. Greater neighborhood disadvantage was associated with higher CVD risk. Tract-level optimism attenuated this association, whereas tract-level anger amplified it. Effects of optimism were stronger among Black participants, whereas anger more strongly exacerbated risk among Hispanic participants.
Psychosocial resilience and risk factors modify the impact of neighborhood disadvantage on CVD, with important ethnoracial differences.
Structural and community-partnered strategies are needed to address ethnoracial differences in how psychosocial factors modify the cardiovascular effects of neighborhood disadvantage. (
2026;116(5):711-721. https://doi.org/10.2105/AJPH.2025.308407).
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Details
- Title
- Psychosocial Risk and Resilience as Moderators of the Association Between Neighborhood Disadvantage and Incident Cardiovascular Disease Across Ethnoracial Groups: Multi-Ethnic Study of Atherosclerosis, United States, 2000-2019
- Creators
- Hannah Pleasants - University of North Carolina at Chapel HillJames R Pike - New York UniversityPriya Palta - University of North Carolina at Chapel HillAlain G Bertoni - Wake Forest UniversityTimothy M Hughes - Wake Forest UniversityQian Xiao - The University of Texas Health Science Center at HoustonJana A Hirsch - Drexel UniversityGanga S Bey (Corresponding Author) - University of North Carolina at Chapel Hill
- Publication Details
- American journal of public health (1971), v 116(5), pp 711-721
- Publisher
- American Public Health Association
- Number of pages
- 11
- Grant note
- National Heart, Lung, and Blood Institute: 75N92025D00022, 75N92020D00001, HHSN268201500003I, N01-HC-95159, 75N92025D00026, 75N92020D00005, N01-HC-95160, 75N92020D00002, N01-HC-95161, 75N92025D00024, 75N92020D00003, N01-HC-95162, 75N92025D00027, 75N92020D00006, N01-HC-95163, 75N92025D00025, 75N92020D00004, N01-HC-95164, 75N92025D00028, 75N92020D00007, N01-HC-95165, N01-HC-95166, N01-HC-95167, N01-HC-95168, N01-HC-95169 National Center for Advancing Translational Sciences: UL1-TR-000040, UL1-TR-001079, UL1-TR-001420
This research was supported by the National Heart, Lung, and Blood Institute (contracts 75N92025D00022, 75N92020D00001, HHSN268201500003I, N01-HC-95159, 75N92025D00026, 75N92020D00005, N01-HC-95160, 75N92020D00002, N01-HC-95161, 75N92025D00024, 75N92020D00003, N01-HC-95162, 75N92025D00027, 75N92020D00006, N01-HC-95163, 75N92025D00025, 75N92020D00004, N01-HC-95164, 75N92025D00028, 75N92020D00007, N01-HC-95165, N01-HC-95166, N01-HC-95167, N01-HC-95168, and N01-HC-95169) and the National Center for Advancing Translational Sciences (grants UL1-TR-000040, UL1-TR-001079, and UL1-TR-001420) . The authors thank the other investigators, staff, and participants of the MESA study for their valuable contributions. A full list of participating MESA investigators and institutions can be found at https://mesa-nhlbi.org. This article has been reviewed and approved by the MESA Publications and Presentations Committee. Note. The contents of this article are solely the responsibility of the authors and do not necessarily represent the official views of the funders.
- Resource Type
- Journal article
- Language
- English
- Academic Unit
- Epidemiology and Biostatistics
- Web of Science ID
- WOS:001744263400029
- Other Identifier
- 991022172857204721