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Neighborhood Influences on Cardiovascular Health: A Concept Mapping Study With Young Black Men Living in Southern
Samuel L K Baxter1, Aaron J Neal2, Richard J Chung3
1Department of Health Policy and Management, Gillings School of Global Public Health, The University of North Carolina at Chapel Hill, Chapel Hill, NC, USA.
Abstract:
Cardiovascular health (CVH) is both a concept and a measure that refers to health behaviors and clinical factors that help prevent cardiovascular disease (CVD). The neighborhood environment is increasingly recognized as a crucial social determinant of CVH, especially for Black populations. The purpose of this participatory concept mapping (CM) study was to (1) understand perspectives on neighborhood features that influence health and (2) identify which features are most important to achieving CVH behaviors for young Black men. We conducted CM with Black men (n = 30), ages 18 to 34, living in two majority Black communities in one southeastern state. The CM process included three sequential phases-brainstorming, structuring, and interpretation. We defined CVH behaviors as having a healthy diet, healthy weight, engaging in sufficient physical activity, and no tobacco use. Participants depicted neighborhood characteristics across 45 statements that were grouped into eight conceptual clusters. Clusters were rated in terms of relative importance to achieving CVH behaviors. Participants ranked the Economic Opportunity and Health Choices clusters as the most important to achieving CVH behaviors. Conversely, Economic Stressors and Environmental Stressors had the lowest rating of relative importance to achieving CVH behaviors. Pattern matching revealed that average cluster ratings of importance to CVH behaviors achievement were ranked similarly across city type (metropolitan vs. small city) and neighborhood racial composition (most Black vs. racially diverse), but with some nuance. This participant-driven process highlights the neighborhood environment as a meaningful social determinant of fostering or undermining CVH behaviors for young Black men.
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