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Abstract Background Air pollution is a major risk factor for cardiovascular diseases and contributes to health disparities, particularly among minority ethnic groups, who often face higher exposure levels. Knowledge on whether the effect of air pollution on cardiovascular diseases differs between ethnic groups is crucial for identifying mechanisms underlying health disparities, ultimately informing targeted public health strategies and interventions. We explored differences in associations between air pollution and ischemic stroke and ischemic heart disease (IHD) for the six largest ethnic groups in the Netherlands. Methods This nationwide analysis (2014–2019), linked residential-address concentrations of NO2 and PM2.5 to individual-level hospital and mortality data. To evaluate incident ischemic stroke, we created a cohort of residents ≥30 years and free of ischemic stroke at baseline and for incident IHD we created a cohort free of IHD. We performed Cox proportional hazard survival analyses in each cohort with 2014 average concentrations of PM2.5 or NO2 as determinants, stratified by ethnicity (Dutch, German, Indonesian, Surinamese, Moroccan, Turkish) and adjusted for age, sex, socioeconomic indicators and region. Results Both cohorts included > 9.5 million people. During follow-up, 127,673 (1.3%) developed ischemic stroke and 156,517 (1.6%) developed IHD. For ischemic stroke, the p-values for the interaction between air pollution and ethnicity were 0.057 for NO2 and 0.055 for PM2.5. The HR of 1 IQR increase (6.42 µg/m3) of NO2 for ischemic stroke was lowest for Moroccans (0.92 [0.84–1.02], p-value = 0.032 difference with Dutch) and highest for Turks (1.09 [1.00-1.18], p-value = 0.157 difference with Dutch). PM2.5 results were similar. For IHD, higher exposure was unexpectedly associated with lower incidence. The p-values for the interaction with ethnicity were 1.75*10− 5 for NO2 and 1.06*10− 3 for PM2.5. The HRs for IHD were lowest for Turks (NO2: 0.88 [0.83–0.92], p-value = 2.0*10− 4 difference with Dutch, PM2.5: 0.86 [0.82–0.91], p-value = 1.3*10− 4 difference with Dutch) and highest for Surinamese (NO2: 1.02 [0.97–1.07], p-value = 0.014 difference with Dutch) and Dutch (PM2.5: 0.96 [0.94–0.98]). Conclusions Associations between air pollutants and ischemic stroke or IHD differ notably between ethnic groups in the Netherlands. Policies to reduce air pollution and prevent ischemic stroke should target populations vulnerable to air pollution with a high cardiovascular disease risk.

Abstract Background The use of urban green spaces differs by social characteristics, including gender, ethnicity, and socioeconomic position. We examined motives, means and prerequisites to visit green space of marginalised populations with high cardiometabolic risk in the Netherlands, namely women with a Turkish or South Asian Surinamese background residing in disadvantaged neighbourhoods. Methods We conducted six focus group discussions in two Dutch cities. The study was performed in collaboration with social workers from the local communities with similar ethnic backgrounds as the participants. A thematic analysis was carried out. Results Sixteen Turkish women and 30 South Asian Surinamese women participated. Motives, means and prerequisites that emerged covered four themes: social, personal, environmental characteristics and undertaking activities. Socializing was an important motive to visit green space. Personal motives mainly consisted of positive effects on mental and physical well-being. Activities undertaken in green space were often a means to socialize or improve well-being. Many environmental factors, including safety, aesthetics, and (sanitary) facilities, influenced motivation to visit green space. Except for environmental characteristics, motives, means and prerequisites largely overlapped between ethnic groups. There were notable interactions between the themes. Conclusion Motives, means and prerequisites to visit green space of women with a Turkish or South Asian Surinamese background who live in disadvantaged neighborhoods span multiple interacting themes. Future studies examining the relationship between green space and health should consider interactions between motives, means, prerequisites and ethnicity. The possibility of expanding the multifunctionality of green spaces to provide marginalized populations with more equitable access and activities should be further explored.

Objectives: To gain insight in the motives and determinants for the uptake of healthy lifestyles by South-Asian Surinamese people to identify needs and engagement strategies for healthy lifestyle support.Methods: We used a mixed-method design: first, focus groups with South-Asian Surinamese women; second, a questionnaire directed at their social network, and third, interviews with health professionals. Qualitative content analysis, basic statistical analyses and triangulation of data were applied.Results: Sixty people participated (n = 30 women, n = 20 social network, n = 10 professionals). Respondent groups reported similar motives and determinants for healthy lifestyles. In general, cardiometabolic prevention was in line with the perspectives and needs of South-Asian Surinamese. However, there seems to be a mismatch too: South-Asian Surinamese people missed a culturally sensitive approach, whereas professionals experienced difficulty with patient adherence. Incremental changes to current lifestyles; including the social network, and an encouraging approach seem to be key points for improvement of professional cardiometabolic prevention.Conclusion: Some key points for better culturally tailoring of preventive interventions would meet the needs and preferences of the South-Asian Surinamese living in the Netherlands.