Race, Neighborhood Economic Status, Income Inequality and Mortality

<div><p>Mortality rates in the United States vary based on race, individual economic status and neighborhood. Correlations among these variables in most urban areas have limited what conclusions can be drawn from existing research. Our study employs a unique factorial design of race, sex, age and individual poverty status, measuring time to death as an objective measure of health, and including both neighborhood economic status and income inequality for a sample of middle-aged urban-dwelling adults (N = 3675). At enrollment, African American and White participants lived in 46 unique census tracts in Baltimore, Maryland, which varied in neighborhood economic status and degree of income inequality. A Cox regression model for 9-year mortality identified a three-way interaction among sex, race and individual poverty status (p = 0.03), with African American men living below poverty having the highest mortality. Neighborhood economic status, whether measured by a composite index or simply median household income, was negatively associated with overall mortality (p<0.001). Neighborhood income inequality was associated with mortality through an interaction with individual poverty status (p = 0.04). While racial and economic disparities in mortality are well known, this study suggests that several social conditions associated with health may unequally affect African American men in poverty in the United States. Beyond these individual factors are the influences of neighborhood economic status and income inequality, which may be affected by a history of residential segregation. The significant association of neighborhood economic status and income inequality with mortality beyond the synergistic combination of sex, race and individual poverty status suggests the long-term importance of small area influence on overall mortality.</p></div

Characteristics of the Healthy Aging in Neighborhoods of Diversity Across the Life Span Study Participants, Baltimore, Maryland, 2004–2013 (N = 3675).

<p>Characteristics of the Healthy Aging in Neighborhoods of Diversity Across the Life Span Study Participants, Baltimore, Maryland, 2004–2013 (N = 3675).</p

Frailty in a racially and socioeconomically diverse sample of middle-aged Americans in Baltimore.

Frailty is a risk factor for disability and mortality, and is more prevalent among African American (AA) elderly than whites. We examine frailty in middle-aged racially and economically diverse adults, and investigate how race, poverty and frailty are associated with mortality. Data were from 2541 participants in the Healthy Aging in Neighborhoods of Diversity across the Life Span study in Baltimore, Maryland; 35-64 years old at initial assessment (56% women; 58% AA). Frailty was assessed using a modified FRAIL scale of fatigue, resistance, ambulation, illness and weight loss, and compared with difficulties in physical functioning and daily activities. Frailty prevalence was calculated across race and age groups, and associations with survival were assessed by Cox Regression. 278 participants were frail (11%); 924 pre-frail (36%); 1339 not frail (53%). For those aged 45-54, a higher proportion of whites (13%) than AAs (8%) were frail; while the proportions were similar for those 55-64 (14%,16%). Frailty was associated with overall survival with an average follow-up of 6.6 years, independent of race, sex and poverty status (HR = 2.30; 95%CI 1.67-3.18). In this sample of economically and racially diverse older adults, the known association of frailty prevalence and age differed across race with whites having higher prevalence at younger ages. Frailty was associated with survival beyond the risk factors of race and poverty status in this middle-aged group. Early recognition of frailty at these younger ages may provide an effective method for preventing or delaying disabilities

Inflammatory proteins are associated with mortality in a middle‐aged diverse cohort

Abstract Background Recent data indicate a decline in overall longevity in the United States. Even prior to the COVID‐19 pandemic, an increase in midlife mortality rates had been reported. Life expectancy disparities have persisted in the United States for racial and ethnic groups and for individuals living at low socioeconomic status. These continued trends in mortality indicate the importance of examining biomarkers of mortality at midlife in at‐risk populations. Circulating levels of cytokines and inflammatory markers reflect systemic chronic inflammation, which is a well‐known driver of many age‐related diseases. Methods In this study, we examined the relationship of nine different inflammatory proteins with mortality in a middle‐aged socioeconomically diverse cohort of African–American and White men and women (n = 1122; mean age = 47.8 years). Results We found significant differences in inflammatory‐related protein serum levels between African–American and White middle‐aged adults. E‐selectin and fibrinogen were significantly higher in African–American adults. IFN‐γ, TNF‐α trimer, monocyte chemoattractant protein‐1 (MCP‐1), soluble receptor for advanced glycation end‐products (sRAGE) and P‐selectin were significantly higher in White participants compared to African–American participants. Higher levels of E‐selectin, MCP‐1 and P‐selectin were associated with a higher mortality risk. Furthermore, there was a significant interaction between sex and IL‐6 with mortality. IL‐6 levels were associated with an increased risk of mortality, an association that was significantly greater in women than men. In addition, White participants with high levels of sRAGE had significantly higher survival probability than White participants with low levels of sRAGE, while African–American participants had similar survival probabilities across sRAGE levels. Conclusions These results suggest that circulating inflammatory markers can be utilized as indicators of midlife mortality risk in a socioeconomically diverse cohort of African–American and White individuals

Healthy Behaviors Associated with Changes in Mental and Physical Strength in Urban African American and White Adults

Over time, adherence to healthy behaviors may improve physical and mental strength which is essential for successful aging. A plausible mechanism is the reduction of inflammation. Research on the association of risky health behaviors on change in strength with age is limited. This study examined changes in the inflammatory potential of the diet, smoking, illicit drug use with changes in strength in a racially and socioeconomically diverse adult sample from the Healthy Aging in Neighborhoods of Diversity Across the Life Span study. The dietary inflammatory index (DII) was calculated from 35 food components derived from multiple 24-h dietary recalls. Strength was evaluated by handgrip strength (HGS), SF-12 PCS and SF-12 MCS (physical and mental component scores). Repeated measures analyses were used to examine associations. At baseline, mean age was 48.4 ± 0.25 years, 56% of the sample were women, and 58% African American. Significant 4-way interactions were found between age, race, socioeconomic status, and DII for women, on change in HGS (p &lt; 0.05) and in SF-12 PCS (p &lt; 0.05) and for men, in change in SF-12 PCS (p &lt; 0.05). Improvements in SF-12 MCS were associated with all three health behaviors as main effects. This study provided evidence that changes towards improving healthy behaviors, diet with anti-inflammatory potential, not smoking cigarettes and not using illicit drugs, were associated with improved strength. Health professionals, especially registered dietitians and health coaches, should create lifestyle interventions to reduce inflammation targeting change in more than one risky health behavior

Data from: Does the niche-breadth or trade-off hypothesis explain the abundance-occupancy relationship in avian haemosporidia?

Two hypotheses have been proposed to explain the abundance-occupancy relationship (AOR) in parasites. The niche-breadth hypothesis suggests that host generalists are more abundant and efficient at colonizing different host communities than specialists. The trade-off hypothesis argues that host specialists achieve high density across their hosts’ ranges, whereas generalists incur the high cost of adaptation to diverse immuno-defense systems. We tested these hypotheses using 386 haemosporidian cytochrome-b lineages (1894 sequences) recovered from 2318 birds of 103 species sampled in NW Africa, NW Iberia, W Greater Caucasus, and Transcaucasia. The number of regions occupied by lineages was associated with their frequency suggesting the presence of AOR in avian Haemosporidia. However, neither hypothesis provided a better explanation for the AOR. Although, the host-generalist Plasmodium SGS1 was over 3 times more abundant than other widespread lineages, both host specialists and generalists were successful in colonizing all study regions and achieved overall high prevalence

Haemosporidian lineages FASTA

The data file is a FASTA alignment of unique haemosporidian lineages identified in the bird samples. The name of each lineage corresponds to the parasite lineage identifier used in the manuscript and associated files. Lineages are identified to genus when species identification was not possible

Race-specific alterations in DNA methylation among middle-aged African Americans and Whites with metabolic syndrome

Metabolic syndrome (MetS) is a cluster of cardiometabolic risk factors for all-cause mortality, cardiovascular disease, and cancer. Identifying epigenetic alterations associated with MetS in African Americans (AAs) and Whites may provide insight into genes that influence its differential health outcomes. We examined DNA methylation (DNAm) and performed an epigenome-wide association study (EWAS) of MetS among AAs and Whites with and without MetS. We assessed age, race and poverty status associated DNAm among AAs (n = 225) and White (n = 233) adults using NCEP-ATP III guidelines. Genome-wide DNAm measurement was assessed using Illumina Infinium Methylation EPIC BeadChip. Differentially methylated positions (DMPs) and differentially methylated regions (DMRs) were identified using dmpFinder and bumphunter. EWAS was performed using CpGassoc. We found significant DMPs associated with age, poverty status and MetS in each race. GSTT1(Glutathione S-Transferase Theta 1) was one of the top-hypermethylated genes and MIPEP (Mitochondrial Intermediate Peptidase) was one of the most hypomethylated genes when comparing AAs with and without MetS. PPP1R13L (Protein Phosphatase 1 Regulatory Subunit 13 Like) was the top hypermethylated and SCD (stearoyl-CoA desaturase-1) was one of the most hypomethylated genes for Whites with and without MetS. EWAS results showed that DNAm differences might contribute to MetS risk among Whites and AAs since different genes were identified in AAs and Whites. We replicated previously identified MetS associated genes and found that Thioredoxin-interacting protein (TXN1P) was statistically significantly differentially expressed only in Whites. Our results may be useful in further studies of genes underlying differences in MetS among AAs and Whites

Distribution of demographic variables and health measures by frailty status.

<p>Distribution of demographic variables and health measures by frailty status.</p

Frailty prevalence by race and age group.

<p>Frailty prevalence by race and age group.</p