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Journal article
Association between spatial social polarisation and high blood pressure in older adults
Journal of epidemiology and community health (1979), v 79(9), pp 712-718
24 Mar 2025
PMID: 40127909
Featured in Collection : UN Sustainable Development Goals @ Drexel
Abstract
Background
Using data from the Cardiovascular Health Study (CHS) and the REasons for Geographic And Racial Differences in Stroke (REGARDS) study, we investigate the association between socioeconomic polarisation and blood pressure outcomes in black and white adults. We also validate previous findings that joint racial/ethnic and income measures of spatial social polarisation (SSP) outperform single domain measures.
Methods
We conducted a cross-sectional analysis using a retrospective cohort combining CHS (recruited 1989–1990 and 1992–1993) and REGARDS (recruited 2003–2007). The study included 5888 CHS participants aged ≥65 years and 30 183 REGARDS participants aged ≥45 years. SSP was measured using the Index of Concentration at the Extremes for education, race/ethnicity, income, home ownership, and joint race/ethnicity and income at ZIP code, census tract and county levels. The SSP measures were modelled against the presence of high blood pressure and systolic blood pressure.
Results
The sample had a mean age of 66 (SD: 9), was majority female (56%), white/other (63%), and at least high school graduates (85%). A total of 26% had high blood pressure, with a mean systolic blood pressure of 129 mm Hg (SD: 18). Census tract-level models showed low-income black areas had 25% (95% CI 11%–40%) higher odds of high blood pressure and 1.8 mm Hg (95% CI 1.0–2.5) higher mean systolic blood pressure than high-income White areas.
Conclusion
Greater SSP is associated with a higher risk of high blood pressure and higher systolic blood pressure. Further investigating and reducing polarisation could help mitigate cardiovascular health disparities, improving outcomes for socioeconomically deprived communities.
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Details
- Title
- Association between spatial social polarisation and high blood pressure in older adults
- Creators
- Hoda S. Abdel Magid - University of Southern CaliforniaSamuel Jaros - Stanford UniversityGina S. Lovasi - Drexel UniversityAndrea L. Rosso - University of PittsburghAnnabel X. Tan - Stanford UniversityDavid H. Rehkopf - Stanford UniversityLorene M. Nelson - Stanford UniversityMichelle Carlson - Johns Hopkins UniversitySuzanne E. Judd - University of Alabama at BirminghamMichelle C. Odden - Stanford University
- Publication Details
- Journal of epidemiology and community health (1979), v 79(9), pp 712-718
- Publisher
- BMJ Publishing Group
- Number of pages
- 7
- Grant note
- R00HL161479 / National Heart, Lung, and Blood Institute (http://dx.doi.org/10.13039/100000050) Funding HSAM is supported by the National Heart, Lung, and Blood Institute (R00HL161479). SJaros is supported by the National Institute on Drug Abuse (F31DA057107). GSL is supported by the National Institute on Aging (R56AG049970). LMN is supported by the National Institute of Neurological Disorders and Stroke (U01NS038455), the National Center for Advancing Translational Sciences (UL1TR003142), the National Heart, Lung, and Blood Institute (T32HL151323), UCB Biopharma (not applicable), the Lawrence Livermore National Laboratory (not applicable) and Congressionally Directed Medical Research Programmes (B659350). SJudd is supported by the National Institute of Neurological Disorders and Stroke and the National Institute on Aging (U01NS041588). The Cardiovascular Health Study (CHS) is supported by contracts HHSN268201200036C, HHSN268200800007C, HHSN268201800001C, N01HC55222, N01HC85079, N01HC85080, N01HC85081, N01HC85082, N01HC85083, N01HC85086 and 75N92021D00006; the National Heart, Lung, and Blood Institute (U01HL080295, U01HL130114); the National Institute of Neurological Disorders and Stroke; and the National Institute on Aging (R01AG023629). A full list of principal CHS investigators and institutions can be found at chs-nhlbi.org. The Reasons for Geographic and Racial Differences in Stroke (REGARDS) study is supported by the National Institute of Neurological Disorders and Stroke and the National Institute on Aging (U01NS041588). A full list of participating REGARDS investigators and institutions can be found at uab.edu/soph/regardsstudy. The content is solely the responsibility of the authors and does not necessarily represent the official views of the funders. Representatives of the CHS and REGARDS studies were involved in the review of the manuscript but were not directly involved in the collection, management, analysis or interpretation of the data.
- Resource Type
- Journal article
- Language
- English
- Academic Unit
- Urban Health Collaborative; Dana and David Dornsife School of Public Health; Epidemiology and Biostatistics
- Web of Science ID
- WOS:001451892200001
- Scopus ID
- 2-s2.0-105001388959
- Other Identifier
- 991022041864304721
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- Collaboration types
- Domestic collaboration
- Web of Science research areas
- Public, Environmental & Occupational Health