Neighborhood Characteristics and Hypertension
- 1 July 2008
- journal article
- research article
- Published by Ovid Technologies (Wolters Kluwer Health) in Epidemiology
- Vol. 19 (4), 590-598
- https://doi.org/10.1097/ede.0b013e3181772cb2
Abstract
The goal of this study was to investigate cross-sectional associations between features of neighborhoods and hypertension and to examine the sensitivity of results to various methods of estimating neighborhood conditions. We used data from the Multi-Ethnic Study of Atherosclerosis on 2612 individuals 45–85 years of age. Hypertension was defined as systolic blood pressure above 140 mm Hg, diastolic pressure above 90 mm Hg, or use of antihypertensive medications. Neighborhood (census tract) conditions potentially related to hypertension (walking environment, availability of healthy foods, safety, social cohesion) were measured using information from a separate phone survey conducted in the study neighborhoods. For each neighborhood we estimated scale scores by aggregating residents’ responses using simple aggregation (crude means) and empirical Bayes estimation (unconditional, conditional, and spatial). These estimates of neighborhood conditions were linked to each study participant based on the census tract of residence. Two-level binomial regression methods were used to estimate adjusted associations between neighborhood conditions and hypertension. Residents of neighborhoods with better walkability, availability of healthy foods, greater safety, and more social cohesion were less likely to be hypertensive (relative prevalence [95% confidence interval] for 90th vs. 10th percentile of conditional empirical Bayes estimate = 0.75 [0.64–0.88], 0.72 [0.61–0.85], 0.74 [0.63–0.86], and 0.69 [0.57–0.83]), respectively, after adjusting for site, age, sex, income, and education. Associations were attenuated and often disappeared after additional adjustments for race/ethnicity. Neighborhood walkability, food availability, safety, and social cohesion may be mechanisms that link neighborhoods to hypertension.Keywords
This publication has 35 references indexed in Scilit:
- Neighbourhood environments and mortality in an elderly cohort: results from the cardiovascular health studyJournal of Epidemiology and Community Health, 2004
- Neighborhood Socioeconomic Environment and Incidence of Coronary Heart Disease: A Follow-up Study of 25,319 Women and Men in SwedenAmerican Journal of Epidemiology, 2004
- Neighbourhood characteristics and mortality in the Atherosclerosis Risk in Communities StudyInternational Journal of Epidemiology, 2004
- Residential Environments and Cardiovascular RiskJournal of Urban Health, 2003
- Place effects on health: how can we conceptualise, operationalise and measure them?Social Science & Medicine (1982), 2002
- Neighborhood of Residence and Incidence of Coronary Heart DiseaseThe New England Journal of Medicine, 2001
- Cardiovascular risk factors and the neighbourhood environment: a multilevel analysisInternational Journal of Epidemiology, 1999
- Neighbourhood differences in diet: the Atherosclerosis Risk in Communities (ARIC) StudyJournal of Epidemiology and Community Health, 1999
- Individual social class, area-based deprivation, cardiovascular disease risk factors, and mortality: the Renfrew and Paisley StudyJournal of Epidemiology and Community Health, 1998
- Neighborhood Environments and Coronary Heart Disease: A Multilevel AnalysisAmerican Journal of Epidemiology, 1997