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Saucy A, Gehring U, Olmos S, Delpierre C, de Bont J, Gruzieva O, de Hoogh K, Huss A, Ljungman P, Melén E, Persson Å, Pieterson I, Tewis M, Yu Z, Vermeulen R, Vlaanderen J, Tonne C. Effect of residential relocation on environmental exposures in European cohorts: An exposome-wide approach. ENVIRONMENT INTERNATIONAL 2023; 173:107849. [PMID: 36889121 DOI: 10.1016/j.envint.2023.107849] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/01/2022] [Revised: 01/26/2023] [Accepted: 02/22/2023] [Indexed: 06/18/2023]
Abstract
Residential relocation is increasingly used as a natural experiment in epidemiological studies to assess the health impact of changes in environmental exposures. Since the likelihood of relocation can be influenced by individual characteristics that also influence health, studies may be biased if the predictors of relocation are not appropriately accounted for. Using data from Swedish and Dutch adults (SDPP, AMIGO), and birth cohorts (BAMSE, PIAMA), we investigated factors associated with relocation and changes in multiple environmental exposures across life stages. We used logistic regression to identify baseline predictors of moving, including sociodemographic and household characteristics, health behaviors and health. We identified exposure clusters reflecting three domains of the urban exposome (air pollution, grey surface, and socioeconomic deprivation) and conducted multinomial logistic regression to identify predictors of exposome trajectories among movers. On average, 7 % of the participants relocated each year. Before relocating, movers were consistently exposed to higher levels of air pollution than non-movers. Predictors of moving differed between the adult and birth cohorts, highlighting the importance of life stages. In the adult cohorts, moving was associated with younger age, smoking, and lower education and was independent of cardio-respiratory health indicators (hypertension, BMI, asthma, COPD). Contrary to adult cohorts, higher parental education and household socioeconomic position were associated with a higher probability of relocation in birth cohorts, alongside being the first child and living in a multi-unit dwelling. Among movers in all cohorts, those with a higher socioeconomic position at baseline were more likely to move towards healthier levels of the urban exposome. We provide new insights into predictors of relocation and subsequent changes in multiple aspects of the urban exposome in four cohorts covering different life stages in Sweden and the Netherlands. These results inform strategies to limit bias due to residential self-selection in epidemiological studies using relocation as a natural experiment.
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Affiliation(s)
- Apolline Saucy
- Barcelona Institute of Global Health (ISGlobal), Barcelona, Spain; Universitat Pompeu Fabra, Barcelona, Spain; CIBER Epidemiología y Salud Pública, Madrid, Spain
| | - Ulrike Gehring
- Institute for Risk Assessment Sciences, Utrecht University, Utrecht, The Netherlands
| | - Sergio Olmos
- Barcelona Institute of Global Health (ISGlobal), Barcelona, Spain; Universitat Pompeu Fabra, Barcelona, Spain; CIBER Epidemiología y Salud Pública, Madrid, Spain
| | - Cyrille Delpierre
- Centre for Epidemiology and Research in POPulation Health (CERPOP) UMR1295, Inserm, Université Toulouse III Paul Sabatier, Toulouse, France
| | - Jeroen de Bont
- Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Olena Gruzieva
- Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Kees de Hoogh
- Swiss Tropical and Public Health Institute, Allschwil, Switzerland; University of Basel, Basel, Switzerland
| | - Anke Huss
- Institute for Risk Assessment Sciences, Utrecht University, Utrecht, The Netherlands
| | - Petter Ljungman
- Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden; Danderyd Hospital, Department of Cardiology, Stockholm, Sweden
| | - Erik Melén
- Department of Clinical Sciences and Education, Södersjukhuset, Karolinska Institutet, Stockholm, Sweden
| | - Åsa Persson
- Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Inka Pieterson
- Institute for Risk Assessment Sciences, Utrecht University, Utrecht, The Netherlands
| | - Marjan Tewis
- Institute for Risk Assessment Sciences, Utrecht University, Utrecht, The Netherlands
| | - Zhebin Yu
- Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Roel Vermeulen
- Institute for Risk Assessment Sciences, Utrecht University, Utrecht, The Netherlands
| | - Jelle Vlaanderen
- Institute for Risk Assessment Sciences, Utrecht University, Utrecht, The Netherlands
| | - Cathryn Tonne
- Barcelona Institute of Global Health (ISGlobal), Barcelona, Spain; Universitat Pompeu Fabra, Barcelona, Spain; CIBER Epidemiología y Salud Pública, Madrid, Spain.
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Faselis C, Safren L, Allman RM, Lam PH, Brar V, Morgan CJ, Ahmed AA, Deedwania P, Alagiakrishnan K, Sheikh FH, Fonarow GC, Ahmed A. Income disparity and incident cardiovascular disease in older Americans. Prog Cardiovasc Dis 2021; 71:92-99. [PMID: 34320387 DOI: 10.1016/j.pcad.2021.07.010] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/21/2021] [Accepted: 07/21/2021] [Indexed: 12/15/2022]
Abstract
OBJECTIVE To examine the association between income and cardiovascular disease (CVD) in community-dwelling older adults. METHODS Of the 5795 Medicare-eligible community-dwelling older Americans aged 65-100 years in the Cardiovascular Health Study (CHS), 4518 (78%) were free of baseline CVD, defined as heart failure, acute myocardial infarction, stroke, or peripheral arterial disease. Of them, 1846 (41%) had lower income, defined as a total annual household income <$16,000. Using propensity scores for lower income, estimated for each of the 4518 participants, we assembled a matched cohort of 1078 pairs balanced on 42 baseline characteristics. Outcomes included centrally adjudicated incident CVD and mortality. RESULTS Matched participants (n = 2156) had a mean age of 73 years, 63% were women, and 13% African American. During an overall follow-up of 23 years, incident CVD, all-cause mortality and the combined endpoint of incident CVD or mortality occurred in 1094 (51%), 1726 (80%) and 1867 (87%) individuals, respectively. Compared with the higher income group, hazard ratio (HR) for time to the first occurrence of incident CVD in the lower income group was 1.16 with a 95% confidence interval of 1.03 to 1.31. A lower income was also associated with a significantly higher risk of all-cause mortality (HR, 1.19; 95% CI, 1.08-1.30), and consequently a higher risk of the combined endpoint of incident CVD or death (HR, 1.20; 95% CI, 1.09-1.31). CONCLUSION Among community-dwelling older Americans free of baseline CVD, an annual household income <$16,000 is independently associated with significantly higher risks of new-onset CVD and death.
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Affiliation(s)
- Charles Faselis
- Veterans Affairs Medical Center, Washington, DC, United States of America; George Washington University, Washington, DC, United States of America; Uniformed Services University, Washington, DC, United States of America; University of Alabama at Birmingham, Birmingham, AL, United States of America.
| | - Lowell Safren
- Veterans Affairs Medical Center, Washington, DC, United States of America; Georgetown University, Washington, DC, United States of America; MedStar Washington Hospital Center, Washington, DC, United States of America
| | - Richard M Allman
- George Washington University, Washington, DC, United States of America; Georgetown University, Washington, DC, United States of America
| | - Phillip H Lam
- Veterans Affairs Medical Center, Washington, DC, United States of America; Georgetown University, Washington, DC, United States of America; MedStar Washington Hospital Center, Washington, DC, United States of America
| | - Vijaywant Brar
- Veterans Affairs Medical Center, Washington, DC, United States of America; Georgetown University, Washington, DC, United States of America
| | - Charity J Morgan
- George Washington University, Washington, DC, United States of America; Georgetown University, Washington, DC, United States of America
| | - Amiya A Ahmed
- University of Maryland, Baltimore, MD, United States of America
| | - Prakash Deedwania
- Veterans Affairs Medical Center, Washington, DC, United States of America; University of California, San Francisco, CA, United States of America
| | | | - Farooq H Sheikh
- Georgetown University, Washington, DC, United States of America; MedStar Washington Hospital Center, Washington, DC, United States of America
| | - Gregg C Fonarow
- University of California, Los Angeles, CA, United States of America
| | - Ali Ahmed
- Veterans Affairs Medical Center, Washington, DC, United States of America; George Washington University, Washington, DC, United States of America; Georgetown University, Washington, DC, United States of America.
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Brown JR, Hirsch JA, Judd SE, Hurvitz PM, Howard VJ, Safford M, Moore J, Lovasi GS. The Association of Neighborhood Medical Facilities with Aging in Place and Risk of Incident Myocardial Infarction. J Aging Health 2020; 33:227-236. [PMID: 33251918 PMCID: PMC8592305 DOI: 10.1177/0898264320975228] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Objectives: Aging in place (residential stability) is a desirable means of aging where adults remain in their homes, even when facing challenges that impair their capacity for self-care. Residential stability, especially following acute health challenges, depends on individual and community factors, possibly including proximity to medical facilities. Methods: We explored the association between the density of medical facilities around homes with risk of incident myocardial infarction (MI) and with aging in place following incident MI. Results: Densities of neighborhood pharmacies were not associated with aging in place or time to MI. High densities of neighborhood clinical care facilities were significantly associated with decreased residential stability. Discussion: The lack of significant associations between medical facility exposures and MI-related outcomes, coupled with prior findings, casts doubt on their salience and may indicate that other neighborhood features are more strongly associated with these outcomes.
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Affiliation(s)
- Janene R Brown
- Urban Health Collaborative, 6527Drexel University, PA, USA
| | - Jana A Hirsch
- Urban Health Collaborative, 6527Drexel University, PA, USA
| | | | | | | | - Monika Safford
- Weill Cornell Medical College, Cornell University, NY, USA
| | - Jeffrey Moore
- Urban Health Collaborative, 6527Drexel University, PA, USA
| | - Gina S Lovasi
- Urban Health Collaborative, 6527Drexel University, PA, USA
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The Association between Residence Floor Level and Cardiovascular Disease: The Health and Environment in Oslo Study. JOURNAL OF ENVIRONMENTAL AND PUBLIC HEALTH 2016; 2016:2951658. [PMID: 28053608 PMCID: PMC5174177 DOI: 10.1155/2016/2951658] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/24/2016] [Accepted: 10/26/2016] [Indexed: 11/30/2022]
Abstract
Background. Increasingly more people live in tall buildings and on higher floor levels. Factors relating to floor level may protect against or cause cardiovascular disease (CVD). Only one previous study has investigated the association between floor level and CVD. Methods. We studied associations between floor of bedroom and self-reported history of stroke, venous thromboembolism (VTE), and intermittent claudication (IC) among 12.525 inhabitants in Oslo, Norway. We fitted multivariate logistic regression models and adjusted for sociodemographic variables, socioeconomic status (SES), and health behaviors. Additionally, we investigated block apartment residents (N = 5.374) separately. Results. Trend analyses showed that disease prevalence increased by floor level, for all three outcomes. When we investigated block apartment residents alone, the trends disappeared, but one association remained: higher odds of VTE history on 6th floor or higher, compared to basement and 1st floor (OR: 1.504; 95% CI: 1.007–2.247). Conclusion. Floor level is positively associated with CVD, in Oslo. The best-supported explanation may be residual confounding by building height and SES. Another explanation, about the impact of atmospheric electricity, is also presented. The results underline a need to better understand the associations between residence floor level and CVD and multistory housing and CVD.
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