A good neighborhood is good for your heart

There's no place like home, it would seem, with regard to cardiovascular health. New research suggests that living in an inclusive neighborhood with helpful and friendly neighbors could reduce the risk of heart attack.

How do you feel about the area in which you live? Feeling included and surrounded by friendly PEOPLE could reduce the risk of heart attack.

A study conducted by a team from the UNIVERSITY of Michigan has been published online in the Journal of Epidemiology & Community Health, examining the potential health-enhancing effects that the positive characteristics of local neighborhoods could have on the PEOPLE living there.

According to the authors, the majority of previous research has focused on the impact of negative neighborhood characteristics on cardiovascular health, such as the density of FAST FOOD RESTAURANTS, drug use, noise and vandalism. 

These studies have reported that negative neighborhood factors are linked to poorer health.

The authors say there has been a growing body of research finding that positive neighborhood characteristics, such as perceived social cohesion, are associated with positive health outcomes: BETTER HEALTH behaviors, mental health and physical health, for example.

The authors identify social cohesion as "the perceived DEGREE of connectedness between and among neighbors and their willingness to intervene for the common good," and it is characterized by feelings of security, trust and a connection with the neighborhood.

In what is the first known study to examine the association between perceived neighborhood social cohesion and heart attacks, the authors have found that the more cohesive the residents found their neighborhood, the lower their risk of heart attack.

Assessing the neighborhood

Over 5,000 adults in the US participating in the nationally representative Health and Retirement Study were tracked over a period of 4 years, beginning in 2006. The participants had no known heart problems and an average age of 70. Almost two thirds of the participants (62%) were women and married.

At the beginning of the study, the participants were asked to rate their neighborhood in the following different areas using a seven-point scale:

• How much they felt a part of the neighborhood
• If they felt they had neighbors that would help if they got into difficulty
• If they trusted most people in the neighborhood
• If they felt that their neighbors were friendly.

During the monitoring period, 148 of the 5276 participants had a heart attack. The researchers found that each increase in neighborhood social cohesion on the seven-point scale correlated with a reduction in the risk of heart attack of 17%. Each standard deviation increase in perceived neighborhood cohesion was associated with a 22% reduction.

Even after adjusting for other potentially influential factors, such as age, race, gender, social integration and underlying health issues, the researchers found that this association held true.

The results are consistent with previous studies that found associations between positive neighborhood social climate and cardiovascular events.

Love thy neighbor

The authors believe that the association between neighborhood social cohesion and cardiovascular health could be explained by similar mechanisms that lead to an association between higher individual-level social support and BETTER HEALTH outcomes:

"Perceived neighborhood social cohesion could be a type of social support that is available in the neighborhood social environment outside the realm of family and friends. Further, this additional type of neighborhood-level social support may create and reinforce neighborhood norms. These norms may then impact the behavior of neighborhood residents by creating a system of incentives for adopting and maintaining certain BEHAVIORS."

The research does have its limitations, being a purely observational study and unable to analyze the impact of risk factors such as FAMILY HISTORIES of cardiovascular disease and genetic vulnerability. 

The researchers were also unable to examine a wide variety of ethnic groups, and the follow-up period was relatively short.

The authors acknowledge the limitations of their study and suggest that future waves of data collection and releases of data from the Health and Retirement study will allow for more in-depth research to be carried out.

The authors identify that heart disease is the leading cause of death in the US but that the main strategy for combating heart disease has been to try to persuade individuals to change their health behaviors. The authors suggest that a change in approach could be justified:

If future work replicates these findings, this line of research may justify future research which examines the potential HEALTH BENEFITS of policy and public-health interventions that bolster the social infrastructure of neighborhoods.