Abstract Body (Do not enter title and authors here): Background: Residence in socioeconomically disadvantaged neighborhoods and individual sociodemographic determinants of health contribute to worse heart failure (HF) outcomes and may influence HF self-care. However, associations between neighborhood disadvantage, individual sociodemographic conditions, and HF self-care are unclear.
Aims: The purpose of this secondary analysis was to investigate whether neighborhood disadvantage and individual sociodemographic conditions predicted worse HF self-care.
Methods: This study was a secondary analysis of baseline data from a mixed-method study of 82 adults with a 90-day HF readmission. Participant zip codes were assigned a degree of neighborhood disadvantage using the Area Deprivation Index (ADI). Those in the top 20% most disadvantaged neighborhoods (ADI > 80) were compared to those in the least disadvantaged neighborhoods. The self-care of heart failure index was used to measure self-care maintenance and monitoring. Multiple linear regression was conducted.
Results: Of all participants, 59.8% were male, 59.8% were persons of color and the mean age was 64.87 years. Approximately half of study participants resided in a disadvantaged neighborhood (46.6%) and reported an annual household income of $20,000 or less (56.8%). Residing in a disadvantaged neighborhood (B = -10.936, p = .003), living alone (B = -9.984, p = .009), and having no college (B = 8.275, p = 0.027) significantly predicted worse HF self-care maintenance. The model explained 23.7% (R²= .237) of the variation in HF self-care maintenance. Residing in a disadvantaged neighborhood (B = -8.191, p = .022) and living alone (B = -8.372, p = .026) significantly predicted HF self-care monitoring. The model explained 11.8% (R²= .118) of the variation in HF self-care monitoring. While persons of color were more likely to reside in disadvantaged neighborhoods, race was not associated with HF self-care.
Conclusion: Residing in a disadvantaged neighborhood, living arrangements, and education may be important risk factors for worse HF self-care. Differences in self-care were not explained by individual sociodemographic determinants of race, gender, age, annual household income, or marital status. More research is needed to understand the connection between neighborhood disadvantage and HF self-care.