( Sure you think about diet and exercise ...)Living in Poor Neighborhoods Raises Risks for Heart Disease and Stroke,Health

Sure you think about diet and exercise as key to heart disease prevention. But what about the neighborhood you live in? //

According to a new study from the Stanford University School of Medicine, the incidence of heart disease and associated fatalities are higher for people who live in poor neighborhoods vs. those who live in more affluent areas.

'This is one of the largest studies to date to show that neighborhoods exert a pretty powerful influence on your chance of having a heart attack or stroke,' said Marilyn Winkleby, PhD, professor of medicine at the Stanford Prevention Research Center, who conducted the study along with colleagues from the Karolinska Institute in Stockholm and UC-San Francisco. The study appears in the February issue of the American Journal of Preventive Medicine.

'It's not surprising when you think about the health behaviors related to heart disease and stroke - physical inactivity, poor nutrition, smoking - and think about how neighborhoods can influence these,' Winkleby said.

The availability of parks, for instance, or conveniently located markets with fresh produce rather than fast-food restaurants, may make a significant contribution toward differing levels of heart disease, she said.

Researchers analyzed data for the entire Swedish population - 1.9 million women and 1.8 million men living in more than 8,000 neighborhoods. They selected people without any history of coronary heart disease and then followed them from 1996 through 2000 to identify initial occurrences of coronary heart disease and subsequent deaths from heart disease within a year's time of that occurrence.

They found that new cases of heart attacks and stroke were 1.9 times higher for women and 1.5 times higher for men who lived in high-deprivation vs. low-deprivation neighborhoods. Census data was used to determine the level of neighborhood 'deprivation,' which was measured by an index of education,
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