Background It has been hypothesised that the presence of health-damaging factors and lack of health-promoting factors lie in the causal pathway between neighbourhood deprivation and coronary heart disease (CHD). This study is the first to examine the associations between individual-level CHD risk and neighbourhood availability of fast-food restaurants, bars/pubs, physical activity facilities and healthcare resources.
Methods Multilevel logistic regression models were used for the follow-up of 1 065 000 men and 1 100 000 women (aged 35–80 years) between 1 December 2005 and 31 December 2007, for individual-level CHD events (both morbidity and mortality).
Results The relatively weak associations between neighbourhood availability of potentially health-damaging and health-promoting goods, services and resources, and CHD incidence no longer remained significant after adjustment for neighbourhood-level deprivation and individual-level age and income.
Conclusions The presence of potentially health-damaging factors and lack of potentially health-promoting factors do not seem to contribute significantly to the development of CHD. Other features of deprived neighbourhoods appear to play a greater role.
- Multilevel modelling
- small-area epidemiology
- social deprivation
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Funding This work was supported by grants from the Swedish Research Council (K2005-27X-15428-01A, 2008-3110 and 2008-2638), the Swedish Council for Working Life and Social Research (2006-0386, 2007-1754 and 2007-1962) and Formas, the Swedish Research Council for Environment, Agricultural Sciences and Spatial Planning (2006-4255-6596-99 and 2007-1352).
Competing interests None.
Ethics approval Ethics approval was provided by Lund University.
Provenance and peer review Not commissioned; externally peer reviewed.