All ETDs from UAB

Advisory Committee Chair

Bertha Hidalgo

Advisory Committee Members

Ryan Irvin

Leann Long

Document Type


Date of Award


Degree Name by School

Master of Science (MS) School of Public Health


Blacks are disproportionately affected by heart failure (HF) and end-stage renal disease (ESRD). While poorer health outcomes in Blacks have been associated with social determinants of health, there are some biological differences worth noting, namely genetic risk variants for both TTR and HBB. These genetic risk variants are known to confer additional risk in the development of heart failure and end-stage renal disease, respectively. While we understand these genetic variants aren’t fully penetrant, and genetics and are not deterministic, we aimed to examine additional factors and mechanisms responsible for the increased risk in HF and ESRD in Blacks. Neighborhood socioeconomic status (nSES) is an environmental exposure known to confer an additional mortality risk beyond individual socioeconomic status. Our primary research objective was to determine the role nSES as a modifier of the association between TTR and HBB genetic variants and their respective cardiorenal outcomes. To test the association between the genetic risk variants and the incident outcomes we used a multivariable Cox proportional hazards regression. We identified and adjusted for potential confounders and while there was insufficient evidence to support our hypothesis, our study suggests that worse cardiorenal risk factors of people in lower nSES neighborhoods may be more indicative in the association between genetic risk variants and cardiorenal outcomes.

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