Neighborhood Social Cohesion and Inflammatory Biomarkers in African American and White Adults Open Access

Neergheen, Vanessa (2017)

Permanent URL: https://etd.library.emory.edu/concern/etds/r207tq167?locale=en
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Abstract

Introduction: Social cohesion is a positive neighborhood characteristic defined by feelings of connectedness and solidarity within a community. Studies have found significant associations between social cohesion and cardiovascular disease (CVD) risk factors and outcomes. Inflammation is one potential physiological pathway linking social cohesion to CVD development, but few studies have evaluated the relationship between social cohesion and inflammatory biomarkers. Prior research has also established that race and gender can modify the effects of neighborhood features, including social cohesion, on CVD risk factors and outcomes.

Methods: Data from the Morehouse and Emory Team Up to Eliminate Health Disparities (META-Health) Study were used to examine the association between social cohesion and inflammatory biomarkers (interleukin-6 (IL-6) and C-reactive protein (CRP)) among African American (n=259) and White (n=259) adults from the Atlanta metropolitan area. Social cohesion was assessed using the social cohesion subscale from the Neighborhood Health Questionnaire. Multivariable linear regression analyses were conducted, controlling for demographic, clinical, behavioral, and psychosocial factors sequentially. Interaction by race and gender was also considered.

Results: In the models adjusted for age, race, gender, and education, social cohesion was significantly associated with IL-6 (β=-0.06, p=0.03) and there was a significant race by social cohesion interaction (β=-0.12, p=0.04) and marginally significant race by gender by social cohesion interaction (β=-0.21, p=0.09). Race-stratified models controlling for age, gender, and education revealed a significant association between social cohesion and IL-6 in African Americans (β=-0.11, p=0.01), but not Whites (β=0.01, p=0.91). For African American women, all models depicted a significant association between social cohesion and IL-6, including the fully adjusted model (β=-0.16, p=0.001). None of the models illustrated a significant relationship for White women, White men, or African American men. The only significant association between social cohesion and CRP was found for women in crude models; this association was non-significant after adjustment.

Conclusion: The effect of social cohesion on IL-6 is modified by race and gender, with the strongest association emerging for African American women. Although the pathways through which social cohesion impacts inflammation remain unclear, it is possible that for African American women social cohesion manifests through neighborhood networks of fictive kin.

Table of Contents

Table of Contents

Introduction - 1

Methods - 3

Study Sample - 3

Measurement of Interleukin-6 and C-Reactive Protein - 4

Measurement of Social Cohesion - 4

Measurement of Covariates - 5

Statistical Methods - 6

Results - 7

Participant Characteristics - 7

Social Cohesion and Inflammatory Biomarkers - 7

Discussion - 8

Limitations - 11

Conclusion - 12

References - 13

Tables - 20

Table 1 - 20

Table 2 - 21

Table 3 - 22

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