January 6, 2021

Older adults in the United States face an elevated burden of cardiovascular health risk-factors and disease. Convenient access to medical facilities such as doctor’s offices or pharmacies may have beneficial impacts on cardiovascular health maintenance and the ability of older adults to remain in their homes as they age. Aging-in-place is a component of healthy aging where older adults are able to age in their homes with the aid of neighborhood amenities, in-home supports, and with support from their social networks. Identifying beneficial neighborhood characteristics may support efforts to identify additional risk factors for cardiovascular disease or identify key components of neighborhoods that support healthy aging.

Janene R. Brown, MPH, doctoral candidate at the Dornsife School of Public Health along with support from Gina S. Lovasi, PhD, co-director of the Urban Health Collaborative, and a team of interdisciplinary researchers leveraged data collected as part of the RECVD (Retail Environment and Cardiovascular Health Disease) project. This data was used to identify and categorize a longitudinal record of all American businesses from 1990-2014. The research team identified neighborhood medical facilities around the homes of participants in the REGARDS (Reasons for Geographic and Racial Differences in Stroke) study. The team used these linked data to investigate whether the density of medical facilities within 5 kilometers around the homes of REGARDS participants (all >45 years of age) is associated with number of days to myocardial infarction (MI) (or heart attack) from the date of their baseline REGARDS interview, or number of days until a move to a new residence following an incident MI episode. 

Results from the study do not indicate that the density of medical facilities in the neighborhood of REGARDS participants is significantly associated with either of these events. However, there is some evidence that participants living in neighborhoods with more clinical care facilities may have an increased risk of moving. Possible explanations for our findings are that the pathway between the density of medical facilities in the immediate neighborhood and the risk of cardiovascular disease is complex and that there are other more relevant neighborhood characteristics or features that could explain this association. Alternately, decisions around whether to move are multifaceted and often deeply personal and could involve other factors beyond the scope of this research. Further investigation of this broader research question is currently underway. This work will continue by exploring other neighborhood features that could potentially be associated with the two outcomes explored in this research study: healthy and unhealthy neighborhood food outlets. 

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