The study examines the relationship between neighborhood characteristics and the incidence of coronary heart disease (CHD) among participants from four diverse regions in the United States. Using data from the Atherosclerosis Risk in Communities Study, researchers constructed a socioeconomic neighborhood score based on factors such as wealth, income, education, and occupation. During a median follow-up of 9.1 years, 615 CHD events occurred in 13,009 participants. Residents of disadvantaged neighborhoods (those with lower summary scores) had a higher risk of CHD compared to those in advantaged neighborhoods, even after controlling for personal income, education, and occupation. Hazard ratios for CHD among low-income individuals living in the most disadvantaged neighborhoods were 3.1 for whites and 2.5 for blacks, compared to high-income individuals in the most advantaged neighborhoods. These associations remained significant after adjusting for established risk factors for CHD. The findings suggest that living in a disadvantaged neighborhood is independently associated with an increased incidence of CHD, highlighting the importance of neighborhood characteristics in health outcomes.The study examines the relationship between neighborhood characteristics and the incidence of coronary heart disease (CHD) among participants from four diverse regions in the United States. Using data from the Atherosclerosis Risk in Communities Study, researchers constructed a socioeconomic neighborhood score based on factors such as wealth, income, education, and occupation. During a median follow-up of 9.1 years, 615 CHD events occurred in 13,009 participants. Residents of disadvantaged neighborhoods (those with lower summary scores) had a higher risk of CHD compared to those in advantaged neighborhoods, even after controlling for personal income, education, and occupation. Hazard ratios for CHD among low-income individuals living in the most disadvantaged neighborhoods were 3.1 for whites and 2.5 for blacks, compared to high-income individuals in the most advantaged neighborhoods. These associations remained significant after adjusting for established risk factors for CHD. The findings suggest that living in a disadvantaged neighborhood is independently associated with an increased incidence of CHD, highlighting the importance of neighborhood characteristics in health outcomes.