Top Things to Know: Neighborhoods and CV Health

Published: December 11, 2023

  1. Neighborhood characteristics are social determinants of health that are integral to the impact of social structures on health. The neighborhoods where individuals reside shape environmental exposures, access to resources, and opportunities.
  2. Neighborhood features relevant to CVH include access to high-quality education, stable housing, public transportation, and jobs; proximity to environmental and industrial exposures, health care facilities, healthy foods, and spaces for congregation, exercise, and recreation; and environmental stressors such as safety.
  3. The definition of a neighborhood is context dependent and varies widely across countries, regions within countries, and across the rural-urban continuum. The absence of a uniform definition of a neighborhood presents a challenge for researchers studying neighborhood health effects.
  4. As the neighborhood is a foremost contributor towards health and well-being across the lifespan, addressing the neighborhood-based environment and its social and structural determinants is fundamental to achieving health equity.
  5. Few studies have examined neighborhood resources as modifiers of the impact of a behavioral intervention on CVH outcomes like diet or physical activity, and findings are mixed.
  6. Living in neighborhoods with higher levels of air pollution has been linked to poorer endothelial function and adverse cardiovascular outcomes including hospitalization and mortality. The most consistent findings are for short- and long-term exposure to ambient air pollution, specifically particulate matter <2.5 μm.
  7. Integrating neighborhood measures into health systems could 1) increase the capacity to identify individuals at increased risk for clinical adversity, and 2) improve care delivery by optimizing strategies for directing and targeting local resources toward those with unmet health-related social needs.
  8. More rigor and consistency in study designs are essential to improve study of policy effects or effectiveness of neighborhood interventions.
  9. Collaborating with communities to address neighborhood barriers or leverage assets may improve the effectiveness of behavioral interventions and inform the design of multilevel interventions to address CVH inequities.
  10. Finally, this Statement provides a roadmap to illustrate how current knowledge regarding the impact of neighborhoods on CVD can be used to develop and implement effective interventions to improve CVH at the population, health system, community, and individual levels.


Kershaw KN, Magnani JW, Diez Roux AV, Camacho-Rivera M, Jackson EA, Johnson AE, Magwood GS, Morgenstern LB, Salinas JJ, Sims M, Mujahid MS; on behalf of the Council on Quality of Care and Outcomes Research; Council on Epidemiology and Prevention; Council on Clinical Cardiology; Council on Hypertension; Council on Cardiovascular and Stroke Nursing; Council on Peripheral Vascular Disease; and Council on the Kidney in Cardiovascular Disease. Neighborhoods and cardiovascular health: a statement from the American HeartAssociation. Circ Cardiovasc Qual Outcomes. Published online December 11, 2023. doi: 10.1161/HCQ.0000000000000124