BOSTON -- It's not just your genetic profile, your health habits, or how much you earn that influences whether you have a heart attack. It's also where you live, Reuters reported on Thursday.

A study in Thursday's ***New England Journal of Medicine*** concludes that the characteristics of U.S. neighborhoods appear to play a key role in health.

Researchers studied 13,009 people in four regions of the country.

After adjusting for factors known to increase or decrease the individual risk of a heart attack, they found that the poorest whites living in the most disadvantaged neighborhoods were 3.1 times more likely to have a heart attack than the richest whites living in wealthier areas.

For poor Blacks in poor neighborhoods, the rate was 2.5 times higher than for richer Blacks in the most advantaged locales.

"This suggests that attributes of neighborhoods themselves may be important to health," said the researchers, led by Dr. Ana Diez Roux of Columbia University in New York.

"A variety of characteristics of neighborhoods, including the availability of resources and services to promote or maintain healthy lifestyles, as well as the physical and social environment, may be related to cardiovascular risk," they said.

For example, "neighborhoods may differ in the amount of tobacco advertising and in the availability and cost of healthful foods," they said.

In an editorial, Michael Marmot of the University College London, agreed that "living in a disadvantaged community may be bad for health because of lack of access to amenities, which in turn may affect access to healthful foods, to opportunities for physical activity, and to medical care and other services."

In addition, "insecurity, fear of crime, suffering from the effects of a low position in the socioeconomic hierarchy, and lack of social support are all features of disadvantaged communities that might increase inequalities in health," Marmot said.

Diez Roux told Reuters the "findings suggest that researchers and communities may need to work together to identify the specific attributes of neighborhoods that may be important to heart disease risk" so they can be changed.

The places examined as part of the atherosclerosis risk in communities study were Forsyth County, North Carolina; Jackson, Mississippi; Washington County, Maryland; and the northwestern suburbs of Minneapolis, Minnesota.

Average household income, house values, education levels, and occupation were used to determine which neighborhoods were disadvantaged and which were not.