Manifestations of Structural Racism and Inequities in Cardiovascular Health Across US Neighborhoods

Across US neighborhoods, are neighborhood-level manifestations of structural racism associated with inequities in cardiovascular health?In this cross-sectional study of 71 915 census tracts, neighborhoods in the highest quintile of structural racism experienced significantly higher prevalence rates of cardiovascular clinical (high blood pressure, obesity, and diabetes) and behavioral (cigarette smoking and no leisure-time physical activity) risk factors and cardiovascular diseases (coronary heart disease and stroke) compared with those in the lowest quintile. Similar results were observed for each domain of structural racism (eg, housing, education, and employment).Findings show that structural racism should be considered when developing health equity–oriented, placed-based interventions.

Corresponding Author: Wayne R. Lawrence, DrPH, MPH, National Institutes of Health, 9609 Medical Center Dr, RM 6E314, Bethesda, MD 20892 (wayne.lawrence@nih.gov).

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