Distinct moderating pathways for psychosocial risk and resilience in the association of neighborhood disadvantage with incident heart failure among Black persons

Accelerated molecular aging in socioeconomically disadvantaged neighborhoods: A racial/ethnic comparison

In the US, racial/ethnic health disparities are undeniable. These disparities partially stem from residing in low socioeconomic neighborhoods, a circumstance to which racial/ethnic minorities are disproportionately exposed. Associations between socioeconomic status (SES) and health may have some underlying molecular mechanisms reflected in the epigenome. Yet, a growing body of research suggests that neighborhood characteristics are not experienced the same way for individuals from differing racial/ethnic backgrounds. The present study evaluated associations between area-based SES and epigenetic age as assessed by the Horvath, Hannum, PhenoAge, and GrimAge epigenetic clocks in a national sample of older non-Hispanic White, non-Hispanic Black, and Hispanic participants. The present study used epigenetic age data from 3790 participants in the 2016 wave of the Health and Retirement Study and census tract SES data from the 2012-2016 American Community Survey. Four epigenetic clocks were regressed on area-based SES, adjusting for age, sex, and educational attainment. Although area-based SES was not significantly associated with Horvath or Hannum clocks, living in lower SES census tracts was associated with older PhenoAge and GrimAge. After considering smoking status, however, only the association with GrimAge remained. Investigating interactions with race/ethnicity suggested that area-based SES was more strongly associated with accelerated Hannum, PhenoAge, and GrimAge among non-Hispanic White participants than for other racial/ethnic groups. These racial/ethnic differences were completely reduced, however, in models that included smoking status. The present results illuminated racially/ethnically distinct patterns of biological (epigenetic aging) and behavioral (smoking) risk for poor health, and suggested that ameliorating low area-based SES may be beneficial for racially/ethnically diverse populations.

The Relationship of Neighborhood Disadvantage, Biological Aging, and Psychosocial Risk and Resilience Factors in Heart Failure Incidence Among Black Persons: A Moderated Mediation Analysis

OBJECTIVES

Deprived living environments contribute to greater heart failure (HF) risk among non-Hispanic Black persons, who disproportionately occupy disadvantaged neighborhoods. The mechanisms for these effects are not fully explicated, partially attributable to an insufficient understanding of the individual factors that contribute additional risk or resilience to the impact of neighborhood disadvantage on health. The objective of this study was, therefore, to clarify the complex pathways over which such exposures act to facilitate more targeted, effective interventions. Given the evidence for a mediating role of biological age and a moderating role of individual psychosocial characteristics in the neighborhood disadvantage-HF link, we tested a moderated mediation mechanism.

METHODS

Using multilevel causal moderated mediation models, we prospectively examined whether the association of neighborhood disadvantage with incident HF mediated through accelerated biological aging, captured by the GrimAge epigenetic clock, is moderated by hypothesized psychosocial risk (negative affect) and resilience (optimism) factors.

RESULTS

Among a sample of 1,448 Black participants in the shared Jackson Heart Study-Atherosclerosis Risk in Communities cohort (mean age 64.3 years), 334 adjudicated incident hospitalized HF events occurred over a median follow-up of 18 years. In models adjusted for age and sex, the indirect (GrimAge-mediated) effect of neighborhood disadvantage was moderated by psychosocial risk such that for every standard deviation increase in negative affect the hazards of HF was 1.18 (95% confidence interval = 1.05, 1.36). No moderated mediation effect was detected for optimism.

DISCUSSION

Findings support the necessity for multilevel interventions simultaneously addressing neighborhood and individual psychosocial risk in the reduction of HF among Black persons.