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. 2022 Oct;31(10):1440-1449.
doi: 10.1089/jwh.2021.0505. Epub 2022 Aug 12.

Gender Disparities Between Neighborhood Social Vulnerability and Psychological Distress Among Patients with Heart Disease

Samaah Sullivan  1   2 , An Young  2   3 , Mariana Garcia  2   3 , Zakaria Almuwaqqat  2   3 , Kasra Moazzami  2   3 , Muhammad Hammadah  3 , Bruno B Lima  3 , Emily G Driggers  2   4 , Oleksiy Levantsevych  2 , Mhmtjamil Alkhalaf  2 , Mohamad Nour Jajeh  2 , Ayman Alkhoder  3 , Lisa Elon  5 , Holly Gooding  6 , Tené T Lewis  2 , Amit J Shah  2   3   7 , J Douglas Bremner  4   7 , Arshed A Quyyumi  3 , Viola Vaccarino  2   3
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Gender Disparities Between Neighborhood Social Vulnerability and Psychological Distress Among Patients with Heart Disease

Samaah Sullivan et al. J Womens Health (Larchmt). 2022 Oct.

Abstract

Background: Psychological stress disorders are twice as prevalent in women with ischemic heart disease compared to men. The disproportionate psychological health experience of these women is not well understood. The objective of this study was to examine whether neighborhood social factors are associated with disparities in psychological health by gender. Materials and Methods: We studied 286 patients with heart disease recruited from Emory-based hospitals in the Myocardial Infarction and Mental Stress 2 Study (n = 286). A global measure of psychological distress was calculated by taking an average of ranks across symptom scales for depression, post-traumatic stress disorder, anxiety, anger, and perceived stress. The social vulnerability index (SVI) was developed by the Centers for Disease Control and Prevention and was used to rank patients' census tracks on 14 social factors. Beta coefficients for mean ranks in psychological distress scores were estimated per 10-unit increase in SVI percentile ranking using multilevel regression models. Results: The mean age of the sample was 51 years, 49% were women, and 66% African American. After adjusting for demographics, cardiovascular risk factors, and antidepressant use, each 10-unit increase in SVI percentile ranking was associated with 4.65 (95% CI: 0.61-8.69; p = 0.02) unit increase in mean scores for psychological distress among women only (SVI-by-gender-interaction = 0.01). These associations were driven by the SVI themes of lower socioeconomic status and poorer access to housing and transportation. Conclusion: Neighborhood social vulnerability may be a psychosocial stressor that potentiates women's susceptibility to adverse psychological and cardiovascular health.

Keywords: gender differences; heart disease; neighborhood; psychological distress; social vulnerability.

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Figures

FIG. 1.
FIG. 1.
Box plot showing the distribution of SVI by gender. SVI, social vulnerability index.
FIG. 2.
FIG. 2.
Unadjusted regression slopes with 95% confidence intervals for the Mean Ranks Psychological Distress Score by Gender for the following: (a) Overall SVI Index, and Individual Themes of (b) Socioeconomic Status; (c) Household Composition; (d) Minority Status & Language; and (e) Housing Type & Transport. Mean ranks psychological distress score modeled using multilevel models to account for clustering of SVI within census tracts. Models were used testing for the interaction of SVI (continuous) and gender. p-values represent gender-by-SVI interactions.
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References

    1. Mehta LS, Beckie TM, DeVon HA, et al. . Acute myocardial infarction in women: A Scientific Statement From the American Heart Association. Circulation 2016;133(9):916–947; doi: 10.1161/CIR.0000000000000351. - DOI - PubMed
    1. Nabel EG. Heart disease prevention in young women: Sounding an alarm. Circulation 2015;132(11):989–991; doi: 10.1161/circulationaha.115.018352. - DOI - PubMed
    1. Gebhard C. Women and acute coronary syndromes: Still up to no good. Eur Heart J 2017;38(14):1066–1068; doi: 10.1093/eurheartj/ehx109. - DOI - PubMed
    1. Mehta PK, Wei J, Wenger NK. Ischemic heart disease in women: A focus on risk factors. Trends Cardiovasc Med 2015;25(2):140–151; doi: 10.1016/j.tcm.2014.10.005. - DOI - PMC - PubMed
    1. Vaccarino V, Bremner JD. Behavioral, emotional and neurobiological determinants of coronary heart disease risk in women. Neurosci Biobehav Rev 2017;74(Pt B):297–309; doi: 10.1016/j.neubiorev.2016.04.023. - DOI - PMC - PubMed

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