Cardiovascular disease (CVD) continues to be the leading cause of death and a major source of health disparities in the Unites States and globally. Efforts to reduce CVD risk and eliminate cardiovascular health disparities have increasingly emphasized the importance of the social determinants of health. Neighborhood environments have emerged as a possible target for prevention and policy efforts. Hence there is a need to better understand the role of neighborhood environments in shaping cardiovascular risk. The MESA (Multi-Ethnic Study of Atherosclerosis) Neighborhood Study provided a unique opportunity to build a comprehensive place-based resource for investigations of associations between specific features of neighborhood physical and social environments and cardiovascular risk factors and outcomes. This review summarizes the approaches used to characterize residential neighborhood environments in the MESA cohort, provides an overview of key findings to date, and discusses challenges and opportunities in neighborhood health effects research. Results to date suggest that neighborhood physical and social environments are related to behavioral and biomedical risk factors for CVD and that cardiovascular prevention efforts may benefit from taking neighborhood context into account.

Highlights

• There is a need for greater understanding of the role of neighborhood environments in shaping population levels of cardiovascular risk and disparities in cardiovascular risk.
• The MESA (Multi-Ethnic Study of Atherosclerosis) Neighborhood Study provides a unique opportunity to investigate the associations of specific features of neighborhood physical and social environments with cardiovascular risk factors and outcomes in a diverse population.
• Neighborhood physical and social environments have measurable impacts on cardiovascular disease risk.
• The consideration of environmental factors may improve policies to improve cardiovascular health and reduce disparities in cardiovascular health.