{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,5]],"date-time":"2026-03-05T15:18:34Z","timestamp":1772723914209,"version":"3.50.1"},"reference-count":44,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"19","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["JAHA"],"published-print":{"date-parts":[[2024,10]]},"abstract":"<jats:sec xml:lang=\"en\">\n            <jats:title>Background<\/jats:title>\n            <jats:p xml:lang=\"en\">Neighborhood\u2010level income is inversely associated with cardiovascular events; however, it is uncertain whether this association varies with immigration status.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec xml:lang=\"en\">\n            <jats:title>Methods and Results<\/jats:title>\n            <jats:p xml:lang=\"en\">\n              We conducted a population\u2010based cohort study of 5.2 million (53% women, 19% immigrants) urban\u2010dwelling people aged \u226540\u2009years without a prior history of cardiovascular disease in Ontario, Canada. Neighborhood\u2010level income was measured in quintiles from quintile 1 (lowest) to quintile 5 (highest), and immigrants were defined as those born outside of Canada who moved to Canada after 1985. We estimated the association between neighborhood\u2010level income and the rate of incident cardiovascular events (hospitalization for stroke or myocardial infarction, or cardiovascular death) using multivariable cause\u2010specific hazards models and added an interaction term to see if the association varies by immigration status. The absolute difference in the rate of cardiovascular events across income quintiles was less pronounced in immigrants than in long\u2010term residents: age\u2010 and sex\u2010adjusted rate per 1000 person\u2010years in quintile 1 versus quintile 5: 5.69 versus 4.10 in immigrants and 8.37 versus 5.87 in long\u2010term residents. In adjusted models, the interaction between immigration status and neighborhoodl evel was significant (\n              <jats:italic>P<\/jats:italic>\n              <jats:sub>interaction<\/jats:sub>\n              &lt;0.001). The hazard of cardiovascular events declined with increasing income among long\u2010term residents (hazard ratio [HR]\n              <jats:sub>Q1vsQ5<\/jats:sub>\n              , 1.46 to HR\n              <jats:sub>Q4vsQ5<\/jats:sub>\n              , 1.10) and immigrants, albeit with a smaller gradient (HR\n              <jats:sub>Q1vsQ5<\/jats:sub>\n              , 1.43 to HR\n              <jats:sub>Q4vsQ5<\/jats:sub>\n              , 1.20).\n            <\/jats:p>\n          <\/jats:sec>\n          <jats:sec xml:lang=\"en\">\n            <jats:title>Conclusions<\/jats:title>\n            <jats:p xml:lang=\"en\">The association between neighborhood\u2010level income and cardiovascular disease incidence varies\u00a0by immigration status. Understanding the social and structural factors associated with residing in low\u2010income neighborhoods can help with the development of prevention programs that improve health for all.<\/jats:p>\n          <\/jats:sec>","DOI":"10.1161\/jaha.124.036511","type":"journal-article","created":{"date-parts":[[2024,9,30]],"date-time":"2024-09-30T09:25:58Z","timestamp":1727688358000},"update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":4,"title":["Association Between Neighborhood\u2010Level Income and the Incidence of Cardiovascular Events Varies by Immigration Status: A Population\u2010Based Cohort Study"],"prefix":"10.1161","volume":"13","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2953-2540","authenticated-orcid":false,"given":"Manav V.","family":"Vyas","sequence":"first","affiliation":[{"name":"Division of Neurology, Department of Medicine University of Toronto Canada"},{"name":"St. Michael\u2019s Hospital\u2010Unity Health Toronto Canada"},{"name":"Institute of Health Policy, Management and Evaluation, Dalla Lana School of Public Health University of Toronto Canada"},{"name":"ICES Toronto Ontario Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hibo","family":"Rijal","sequence":"additional","affiliation":[{"name":"ICES Toronto Ontario Canada"},{"name":"Faculty of Medicine Queen\u2019s University Kingston Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7276-9551","authenticated-orcid":false,"given":"Amy Y. X.","family":"Yu","sequence":"additional","affiliation":[{"name":"Division of Neurology, Department of Medicine University of Toronto Canada"},{"name":"Institute of Health Policy, Management and Evaluation, Dalla Lana School of Public Health University of Toronto Canada"},{"name":"ICES Toronto Ontario Canada"},{"name":"Sunnybrook Research Institute Toronto ON Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3337-233X","authenticated-orcid":false,"given":"Peter C.","family":"Austin","sequence":"additional","affiliation":[{"name":"Institute of Health Policy, Management and Evaluation, Dalla Lana School of Public Health University of Toronto Canada"},{"name":"ICES Toronto Ontario Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4614-7684","authenticated-orcid":false,"given":"Anna","family":"Chu","sequence":"additional","affiliation":[{"name":"ICES Toronto Ontario Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3288-5109","authenticated-orcid":false,"given":"Maria","family":"Santiago\u2010Jimenez","sequence":"additional","affiliation":[{"name":"ICES Toronto Ontario Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4526-0987","authenticated-orcid":false,"given":"Jiming","family":"Fang","sequence":"additional","affiliation":[{"name":"ICES Toronto Ontario Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nadia A.","family":"Khan","sequence":"additional","affiliation":[{"name":"Division of General Internal Medicine, Department of Medicine, Center for Advancing Health Outcomes University of British Columbia Vancouver Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7105-7931","authenticated-orcid":false,"given":"Husam M.","family":"Abdel\u2010Qadir","sequence":"additional","affiliation":[{"name":"Institute of Health Policy, Management and Evaluation, Dalla Lana School of Public Health University of Toronto Canada"},{"name":"ICES Toronto Ontario Canada"},{"name":"Women\u2019s College Hospital Research Institute Toronto Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3444-9928","authenticated-orcid":false,"given":"Moira K.","family":"Kapral","sequence":"additional","affiliation":[{"name":"Institute of Health Policy, Management and Evaluation, Dalla Lana School of Public Health University of Toronto Canada"},{"name":"ICES Toronto Ontario Canada"},{"name":"Division of General Internal Medicine, Department of Medicine University of Toronto Toronto ON Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"276","reference":[{"key":"e_1_3_2_2_2","doi-asserted-by":"publisher","DOI":"10.1136\/jech.58.1.71"},{"key":"e_1_3_2_3_2","doi-asserted-by":"publisher","DOI":"10.1212\/WNL.0000000000003299"},{"key":"e_1_3_2_4_2","doi-asserted-by":"publisher","DOI":"10.1212\/WNL.0b013e31826aac9b"},{"key":"e_1_3_2_5_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM200107123450205"},{"key":"e_1_3_2_6_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.socscimed.2017.07.005"},{"key":"e_1_3_2_7_2","doi-asserted-by":"publisher","DOI":"10.1093\/abm\/kay089"},{"key":"e_1_3_2_8_2","doi-asserted-by":"publisher","DOI":"10.1136\/jech.55.2.111"},{"key":"e_1_3_2_9_2","volume-title":"International Migration","author":"United Nations","year":"2018","unstructured":"United Nations . 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