Neighborhood Disadvantage, Biological Aging, and Psychosocial Factors in Heart Failure Among Black Persons - Innovation in Aging 2025 Vol. 9 No. S2

Sep 29, 2026

Deprived living environments increase heart failure (HF) risk among non-Hispanic Black persons, yet the mechanisms and the roles of individual risk or resilience factors remain insufficiently explained. This study tests a moderated mediation framework in which neighborhood disadvantage affects incident HF through accelerated biological aging measured by the GrimAge epigenetic clock. Multilevel models using data from 1,448 participants in the Jackson Heart Study examine moderation by negative affect and optimism, finding significant moderated mediation by psychosocial risk and no effect for optimism. Results support multilevel interventions addressing both neighborhood and psychosocial risk.

LanguageEnglish

CategoryResearch & Report

FormatPDF

Pages1

Reading Time3 min

AccessFree to download

Background and Objective

Study Mechanism: Moderated Mediation

Data Source and Sample

Results: Negative Affect vs. Optimism

Implications for Interventions

384 Innovation in Aging, 2025, Vol. 9, No. S2 Given the evidence for a mediating role of biological age and a moderating role of individual psychosocial characteristics in the neighborhood disadvantage-HF link, we tested a moderated mediation mechanism. Using multilevel causal moderated mediation models, we prospectively examined whether the association of neighborhood disadvantage with incident HF mediated through accelerated biological aging, captured by the GrimAge epigenetic clock, is moderated by hypothesized psychosocial risk (negative affect) and resilience (optimism) factors. Among a sample of 1,448 Black participants in the shared Jackson Heart Study-Atherosclerosis Risk in Communities cohort (mean age 64.3 years), 334 adjudicated incident hospitalized HF events occurred over a median follow-up of 18 years. In models adjusted for age and sex, the indirect (GrimAge-mediated) effect of neighborhood disadvantage was moderated by psychosocial risk such that for every standard deviation increase in negative affect the hazards of HF was 1.18 (95% confidence interval = 1.05, 1 .36) . No moderated mediation effect was detected for optimism. Findings support the necessity for multilevel interventions simultaneously addressing neighborhood and individual psychosocial risk in the reduction of HF among Black persons. Abstract citation ID: igaf122.1305 NEIGHBORHOOD DISADVANTAGE, BIOLOGICAL AGING, AND PSYCHOSOCIAL FACTORS IN HEART FAILURE AMONG BLACK PERSONS Ganga Bey1, James Pike2, Anthony Zannas1, Qian Xiao3, Amil Shah4, and Priya Palta5, 1. The University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, United States, 2. New York University, New York, New York, United States, 3. The University of Texas Health Science Center, Houston, Texas, United States, 4. UT Southwestern Medical Center, Dallas, Texas, United States, 5. UNC School of Medicine, Chapel Hill, North Carolina, United States Deprived living environments contribute to greater heart failure (HF) risk among non-Hispanic Black persons, who disproportionately occupy disadvantaged neighborhoods. The mechanisms for these effects are not fully explicated, partially attributable to an insufficient understanding of the individual factors that contribute additional risk or resilience to the impact of neighborhood disadvantage on health. The objective of this study was to clarify the complex pathways over which such exposures act to facilitate more targeted, effective interventions.

FAQs

What biological pathway links neighborhood disadvantage to incident heart failure in this study?

Neighborhood disadvantage is proposed to increase HF risk through accelerated biological aging captured by the GrimAge epigenetic clock.

How did psychosocial factors influence the neighborhood disadvantage–HF pathway?

Negative affect moderated the indirect GrimAge-mediated effect, while optimism showed no moderated mediation effect.

What study design and data set were used to test these relationships?

Multilevel causal moderated mediation models were applied prospectively using shared cohort data from the Jackson Heart Study-Atherosclerosis Risk in Communities, including 1,448 Black participants.

Sep 29, 2026

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