# The Association between Neighborhood Context, Allostatic Load, and Metabolic Dysfunction-Associated Steatosis Liver Disease in Mexican-origin Farmworkers along the Southern Arizona US/Mexico Border

## TL;DR

This study explores how neighborhood conditions and chronic stress affect liver disease risk in Mexican-origin farmworkers in Southern Arizona.

## Contribution

The study identifies a novel mediating role of Allostatic Load between neighborhood violence and Metabolic Dysfunction-Associated Steatosis Liver Disease.

## Key findings

- 41.1% of the sample exhibited Metabolic Dysfunction-Associated Steatosis Liver Disease (MASLD).
- Perceived neighborhood violence was negatively associated with Allostatic Load (p=0.003).
- Allostatic Load mediated the relationship between perceived violence and MASLD status (p=0.004).

## Abstract

Mexican-origin farmworkers are at an increased risk of Metabolic dysfunction-associated steatosis liver disease (MASLD). They are also susceptible to living in neighborhoods with higher levels of unfavorable social, physical, and economic conditions. The effects on health due to these neighborhood conditions are suggested to be reflected through Allostatic Load (ALoad), the wear and tear of the body due to chronic stress. This study examined associations between perceived neighborhood environment, ALoad, and MASLD.

Data were collected from a community-based sample of 151 Mexican-origin farmworkers residing in the Southern Arizona U.S./Mexico border region. Self-reported data on six dimensions of neighborhood context was collected. Allostatic load was calculated as an index of physiological dysregulation. Hepatic steatosis and fibrosis were assessed by liver stiffness measurements (LSM) and controlled attenuation parameter (CAP) scores via FibroScan®. MASLD were identified as having a CAP score of ≥288 dB/m.

The mean age was 49.7 ±14.1 years, mean BMI 31.9 ±6.5 kg/m2, and 9.9% had type 2 diabetes. The mean CAP score was, M=265.8 ±61.0 with 41.1% of the sample exhibiting MASLD status. Perceived neighborhood violence was not associated with MASLD status; however, it was negatively associated with ALoad, (p=0.003). ALoad was a negative mediator between perceived violence and MASLD status (p=0.004).

The results of this study may inform policy and programmatic efforts, such as context for the development of culturally relevant strategies to reduce Mexican-origin farmworkers’ risk for MASLD that are highly responsive to the structural and systemic forces that shape their lived experience.