Association Between Neighborhood-Level Poverty and Incident Atrial Fibrillation: a Retrospective Cohort Study.

Area of Science:

• Cardiology
• Public Health
• Socioeconomic Determinants of Health

Background:

• Atrial fibrillation (AF) is a major cause of cardiovascular disease and mortality.
• Previous research linked neighborhood factors like poverty to AF risk factors, but not directly to AF incidence.

Purpose of the Study:

• To investigate the association between neighborhood-level poverty and the incidence of atrial fibrillation (AF).

Main Methods:

• Retrospective cohort study of adults aged 30-80 without cardiovascular disease.
• Geocoded addresses linked to census poverty data; categorized poverty into low, intermediate, and high.
• Used mixed-effects models to analyze the association, adjusting for demographic and clinical factors.

Main Results:

• Among 28,858 participants, intermediate poverty was significantly associated with a higher odds of incident AF (aOR 1.23).
• High poverty showed a similar trend but did not reach statistical significance (aOR 1.25).
• Patients in higher poverty areas were more likely to be non-Hispanic Black or Hispanic and have higher AF risk factor rates.

Conclusions:

• Intermediate neighborhood poverty is significantly associated with incident AF in adults without prior cardiovascular disease.
• Addressing neighborhood-level factors is crucial for reducing AF disparities and achieving equitable cardiovascular care.