MPC Member Publications

This database contains a listing of population studies publications written by MPC Members. Anyone can add a publication by an MPC student, faculty, or staff member to this database; new citations will be reviewed and approved by MPC administrators.

Full Citation

Title: Neighborhood cohesion is associated with reduced risk of stroke mortality

Citation Type: Journal Article

Publication Year: 2011

ISSN: 1524-4628; 0039-2499

DOI: 10.1161/STROKEAHA.110.609164 [doi]

PMID: 21493914

Abstract: BACKGROUND AND PURPOSE: Greater social cohesion is related to lower rates of coronary heart disease, but its relation to stroke risk is unstudied. This study examined whether neighborhood social cohesion was protective against stroke mortality and incidence. METHODS: Data come from 5789 participants (60% female; 62% black; mean age, 74.7 years) in a longitudinal study of chronic diseases in the elderly. Stroke mortality, ascertained through December 31, 2007, was verified through the National Death Index; 186 stroke deaths were identified in 11 years of follow-up. Stroke incidence was determined in a subset (N=3816) with linkage to Medicare claims files; 701 first-ever strokes were identified. Cohesion was measured by 6 items assessing frequency of contact and social interactions with neighbors; items were z-scored and averaged. Individual scores were averaged across 82 census block groups, forming a neighborhood-level measure of social cohesion. Marginal Cox proportional hazard models tested the association of neighborhood-level cohesion with stroke mortality and incidence. RESULTS: Each 1-point increase in cohesion related to a 53% reduced risk of stroke mortality (hazard ratio, 0.47; 95% CI, 0.24 to 0.90), adjusting for relevant covariates, including sociodemographics, known stroke risk factors, and neighborhood-level socioeconomic status. A racexcohesion interaction (P=0.04) revealed cohesion was protective in whites (hazard ratio, 0.34; 95% CI, 0.17 to 0.67) but not blacks (hazard ratio, 1.17; 95% CI, 0.35 to 3.86). Cohesion was unrelated to stroke incidence (P>0.5). CONCLUSIONS: Neighborhood-level social cohesion was independently protective against stroke mortality. Research is needed to further examine observed race differences and pathways by which cohesion is health-protective.

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Authors: Clark, Cari Jo; Guo, Hongfei; Lunos, Scott; Aggarwal, Neelum T; Beck, Todd L; Evans, Denis A; Mendes de Leon, Carlos F.; Everson-Rose, Susan A

Periodical (Full): Stroke; a journal of cerebral circulation

Issue: 5

Volume: 42

Pages: 1212-2428

Countries:

IPUMS NHGIS NAPP IHIS ATUS Terrapop