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Published, Version of Record (VoR)CC BY-NC-ND V4.0, Open
Journal article
Associations Between Residential Segregation and Incident Hypertension: The Multi-Ethnic Study of Atherosclerosis
Journal of the American Heart Association, v 11(3), pp e023084-e023084
Feb 2022
PMID: 35048712
Featured in Collection : UN Sustainable Development Goals @ Drexel
Abstract
Background Residential segregation, a geospatial manifestation of structural racism, is a fundamental driver of racial and ethnic health inequities, and longitudinal studies examining segregation's influence on cardiovascular health are limited. This study investigates the impact of segregation on hypertension in a multiracial and multiethnic cohort and explores whether neighborhood environment modifies this association. Methods and Results Leveraging data from a diverse cohort of adults recruited from 6 sites in the United States with 2 decades of follow-up, we used race- and ethnicity-stratified Cox models to examine the association between time-varying segregation with incident hypertension in 1937 adults free of hypertension at baseline. Participants were categorized as residing in segregated and nonsegregated neighborhoods using a spatial-weighted measure. We used a robust covariance matrix estimator to account for clustering within neighborhoods and assessed effect measure modification by neighborhood social or physical environment. Over an average follow-up of 7.35 years, 65.5% non-Hispanic Black, 48.1% Chinese, and 53.7% Hispanic participants developed hypertension. Net of confounders, Black and Hispanic residents in segregated neighborhoods were more likely to develop hypertension relative to residents in nonsegregated neighborhoods (Black residents: hazard ratio [HR], 1.33; 95% CI, 1.09-1.62; Hispanic residents: HR, 1.33; 95% CI, 1.04-1.70). Results were similar but not significant among Chinese residents (HR, 1.20; 95% CI, 0.83-1.73). Among Black residents, neighborhood social environment significantly modified this association such that better social environment was associated with less pronounced impact of segregation on hypertension. Conclusions This study underscores the importance of continued investigations of groups affected by the health consequences of racial residential segregation while taking contextual neighborhood factors, such as social environment, into account.
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Details
- Title
- Associations Between Residential Segregation and Incident Hypertension: The Multi-Ethnic Study of Atherosclerosis
- Creators
- Xing Gao - University of California, BerkeleyKiarri N Kershaw - Department of Preventive Medicine Feinberg School of Medicine Northwestern University Chicago IL.Sharrelle Barber - Drexel UniversityPamela J Schreiner - University of MinnesotaD Phuong Do - University of Wisconsin–MilwaukeeAna V Diez Roux - Drexel UniversityMahasin S Mujahid - University of California, Berkeley
- Publication Details
- Journal of the American Heart Association, v 11(3), pp e023084-e023084
- Grant note
- N01 HC095164 / NHLBI NIH HHS N01 HC095160 / NHLBI NIH HHS N01 HC095168 / NHLBI NIH HHS 75N92020D00006 / NHLBI NIH HHS 75N92020D00001 / NHLBI NIH HHS 75N92020D00002 / NHLBI NIH HHS N01 HC095165 / NHLBI NIH HHS N01 HC095169 / NHLBI NIH HHS N01 HC095162 / NHLBI NIH HHS 75N92020D00005 / NHLBI NIH HHS 75N92020D00003 / NHLBI NIH HHS N01 HC095159 / NHLBI NIH HHS 75N92020D00007 / NHLBI NIH HHS N01 HC095166 / NHLBI NIH HHS N01 HC095163 / NHLBI NIH HHS 75N92020D00004 / NHLBI NIH HHS HHSN268201500003I / NHLBI NIH HHS N01 HC095161 / NHLBI NIH HHS UL1 TR000040 / NCATS NIH HHS UL1 TR001079 / NCATS NIH HHS N01 HC095167 / NHLBI NIH HHS UL1 TR001420 / NCATS NIH HHS
- Resource Type
- Journal article
- Language
- English
- Academic Unit
- Urban Health Collaborative
- Web of Science ID
- WOS:000748956000006
- Scopus ID
- 2-s2.0-85123969834
- Other Identifier
- 991019167976904721
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- Collaboration types
- Domestic collaboration
- Web of Science research areas
- Cardiac & Cardiovascular Systems