Psychosocial Risk and Resilience as Moderators of the Association Between Neighborhood Disadvantage and Incident Cardiovascular Disease Across Ethnoracial Groups: Multi-Ethnic Study of Atherosclerosis, United States, 2000–2019.

This article examines how psychosocial factors—specifically optimism and anger—modify the relationship between neighborhood disadvantage and incident cardiovascular disease (CVD) across different ethnoracial groups in the United States. Using data from 4,326 participants in the Multi-Ethnic Study of Atherosclerosis (MESA) cohort (2000–2019), neighborhood disadvantage was measured by the Area Deprivation Index, while optimism and anger were assessed via validated self-report scales. Results indicate that greater neighborhood disadvantage is associated with higher CVD risk, with neighborhood-level optimism attenuating this risk and neighborhood-level anger amplifying it; these effects vary by ethnoracial group, with optimism showing stronger protective effects among Black participants and anger more strongly exacerbating risk among Hispanic participants. The findings highlight the importance of culturally informed, community-partnered public health strategies that address psychosocial resilience and risk within the context of structural inequities to reduce cardiovascular health disparities.