Cardiovascular health among young adults: Do childhood neighborhoods matter?

We examine the associations between characteristics of young adults' communities and their cardiovascular health. Young adult cardiovascular health (CVH) is assessed by a set of eight factors encompassing both health-related behaviors and clinical metrics. We analyze a recent data collection effort fielded during 2021-2023: The Future of Families - Cardiovascular Health Among Young Adults (FF-CHAYA) study, designed to examine the social determinants of cardiovascular health and subclinical cardiovascular disease among young adults. Participants were subsampled from a longitudinal survey of about 5000 births in large cities in the US that has conducted seven waves of interviews since 1998-2000. A total of 1421 young adults, average age 23, participated in 33 "pop-up" clinics across the US. We use latent transition analysis based on a rich set of contextual variables at the census tract or county level to uncover three profiles of geographic areas of childhood residence around the time of birth and at age nine years. We find significant relationships between young adult CVH and their level of schooling, their racial/ethnic identity, and their neighborhood environments. Associations between spending childhood years in disadvantaged neighborhood archetypes and CVH scores were largely but not entirely attenuated by individual-level characteristics. At this early stage of adulthood, these associations are driven largely by health-related behaviors, particularly physical activity, but linkages with clinical metrics of cardiovascular risk are likely to appear in the coming years and decades.