Where you live can greatly affect the health of your heart and brain


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Liz Harris won’t let anything stop her from walking. Three mornings a week, he descends three flights of stairs and heads for Anacostia Park. It is a 10 minute walk just to get there. If none of your friends are available, walk alone. But they care about her when she does.

“The community is known for crime and you don’t feel comfortable walking alone,” said Harris, 72, who lives in southeast Washington, in District 8. But that’s not his only concern. Dogs untied in the park do it The streets of the road are uneven and in poor condition. Heavy traffic can contribute to poor air quality.

“For the most part, the neighborhood is not conducive to exercise, especially for women,” she said.

Still, Harris walks in because the crime is not known throughout his neighborhood. It also has some of the highest rates of obesity, heart disease and cognitive impairment in the district, according to DC Health Matters Collaborative, a coalition of community hospitals and health centers.

A Report 2018 for the Washington Metropolitan Board of Governors highlights other neighborhood disparities: higher child deaths, child poverty, unemployment, older housing, and longer commutes.

“We’re always on the lower end,” said Mustafa Abdul-Salaam, a longtime community activist who also lives in Ward 8. “We died 15 years before Ward 3 (northwest Washington). says it all. “

There is a lot of research that highlights how the conditions in which people live, work, learn, and play affect their health, especially the heart and therefore the brain. A basic element of these so-called social determinants of health is the neighborhood, with factors such as home security; access to healthy food, transportation and health care; physical activity opportunities; and exposure to pollutants and noise. Lack of public safety, social disorganization, and exposure to high levels of violent crime have also been associated with an increase in , which can cause cognitive impairment.

“All of these converging factors increase a person ‘s vulnerability to them , especially in the poor said Mustafa Hussein, an assistant professor at the Joseph J. Zilber School of Public Health at the University of Wisconsin-Milwaukee.

Hussein led a 2017 study published in American Journal of Epidemiology who found people with they were 60% more likely to suffer a heart attack or stroke like those with a high socioeconomic status, with at least a third of the additional risk attributable to neighborhood conditions.

Others Stroke journal research suggests people living with three or more of these social determinants are almost 2.5 times more likely to suffer a stroke. A 2020 Report in Circulation: Cardiovascular Quality and Outcomes concluded only living in an increase in public housing risk. In his 2019 prevention guidelines, issued jointly with the American College of Cardiology, the American Heart Association said these social inequalities are “strong” risk determinants and can have as great an impact on cardiovascular health as medications and lifestyle changes. life.

Abdul-Salaam sees these impacts first hand. Ward 8 has a lot of natural beauty and green space – important factors in maintaining a healthy neighborhood, he said. But it has no access to healthy and affordable groceries and is a heavy load of commercial and commuter traffic that makes the streets less prone to walking while generating more noise and pollution.

It is one of the scenarios that organizations like the National Complete Streets Coalition are trying to address. The group works to transform roads and design new ones across the country to facilitate navigation on foot, cycling, the use of assistive devices such as walkers and access to public transport. Solutions include sidewalks, wider bike lanes or shoulders, bus lanes, and more comfortable and accessible transportation stops. A 2020 AHA policy statement said these campaigns were vital in promoting “increased physical activity regardless of age, income, racial / ethnic background, ability or disability.” .

The work reaches especially neighborhoods that have historically not seen the same economic and infrastructure investment as others.

To date, 35 state governments and the District of Columbia have adopted full street policies. In Washington, this has led to improvements, some in Ward 8, such as elevated pedestrians and dedicated bike lanes. But community members say much more is needed to help the area thrive.

Abdul-Salaam is helping to lead and facilitate a planning process in Ward 8 to connect residents with government, business and health leaders to collaborate on solutions for Southeast Washington, DC. He is recruiting and training community members to map neighborhood assets and deficits, using a GPS-enabled app. “Then we can identify what we need to add or remove.”

Resident involvement is an important step and neighborhood revitalization is often overlooked, said Dr. Tiffany Powell-Wiley, head of the National Heart, Lung and Blood Institute’s Laboratory of Social Determinants of Obesity and Cardiovascular Risk. . Too often, decisions in low-income communities are made without input from the people who live there, which causes low-income residents to be evicted when neighborhood updates make it more attractive to outsiders and more expensive. .

“There has to be an element of racial equity in the work that is going on,” he said. “If a new policy is established around community development, we must ensure that different racial and ethnic populations benefit equally.”

That doesn’t mean people can’t take individual measurements either, Powell-Wiley said. Work with her such as Harris to design and conduct research on culturally appropriate ways to increase physical activity and improve heart health among black women living in less resource-intensive areas.

“There are ways to use the resources you have,” she said, especially if women form social media to support themselves. “It’s safer to walk in a group, for example.”

But strategies to reduce heart and brain health risks, such as promoting lifestyle change, cannot fully benefit people in underserved communities until the underlying structural challenges are addressed, said Hussein.

“The whole idea of ​​lifestyle choices as something that everyone can take advantage of is misleading, when in reality that choice is limited by what is available to people,” he said. “This is where political solutions or investments in these neighborhoods to compensate for historical divestment become so important.”

Long-term survival after a heart attack may depend on where you live

More information:
Mario Sims et al, Importance of Housing and Cardiovascular Health and Well-Well: A Scientific Statement from the American Heart Association, Circulation: quality and cardiovascular results (2020). DOI: 10.1161 / HCQ.0000000000000089

Citation: Where you live can greatly affect heart and brain health (2021, July 16), retrieved July 16, 2021 at https://medicalxpress.com/news/2021-07-greatly-affect-heart-brain -health.html

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