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Neighborhood-Level Racial and Ethnic Residential Segregation and Incidence of Atrial Fibrillation: The Multi-Ethnic

Utibe R Essien1, Katharine Harrington2, Shaina J Alexandria2

  • 1Division of General Internal Medicine and Health Services David Geffen School of Medicine at the University of California Los Angeles Los Angeles CA USA.

Journal of the American Heart Association
|June 23, 2026
PubMed

Insights

Residential segregation was not associated with atrial fibrillation (AF) incidence in Black, Hispanic/Latino, or White individuals. Further research is needed to understand AF risk factors in diverse populations.

Area of Science:

  • Cardiovascular epidemiology
  • Social determinants of health
  • Arrhythmia research

Background:

  • Atrial fibrillation (AF) is a common arrhythmia with significant health impacts.
  • Underrepresented racial and ethnic groups have lower AF incidence despite higher risk factors.
  • Neighborhood racial and ethnic segregation is a potential structural factor influencing health outcomes.

Purpose of the Study:

  • To investigate the association between neighborhood residential segregation and the incidence of atrial fibrillation (AF).
  • To examine this association across different racial and ethnic groups.

Main Methods:

  • Utilized data from the Multi-Ethnic Study of Atherosclerosis (MESA) cohort.
  • Defined own-group racial and ethnic segregation using the local Gi* statistic.
  • Employed Cox proportional hazard models, stratified by race and ethnicity, with adjustments for multiple covariates.

Main Results:

  • The cohort included 5375 participants: 31% Black, 25% Hispanic/Latino, and 44% White.
  • Over 16.6 years of follow-up, 1035 participants (19.3%) developed AF.
  • Despite higher AF risk factors and segregation prevalence in Black and Hispanic/Latino participants, neighborhood segregation was not significantly associated with AF incidence after full adjustment.

Conclusions:

  • No association was found between residential segregation and AF incidence in Black, Hispanic/Latino, or White participants in fully adjusted models.
  • Further investigation is required to elucidate the complex interplay of individual, clinical, healthcare, and structural factors in driving differential AF risk.
Abstract

Keywords:
atrial fibrillationdisparitiesepidemiologyhealth equitysegregation

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