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Journal article
Gender differences in the association of individual and contextual socioeconomic status with hypertension in 230 Latin American cities from the SALURBAL study: a multilevel analysis
BMC public health, v 23(1), 1532
11 Aug 2023
PMID: 37568082
Featured in Collection : UN Sustainable Development Goals @ Drexel
Abstract
Despite global interest in gender disparities and social determinants of hypertension, research in urban areas and regions with a high prevalence of hypertension, such as Latin America, is very limited. The objective of this study was to examine associations of individual- and area-level socioeconomic status with hypertension in adults living in 230 cities in eight Latin America countries.
In this cross-sectional study, we used harmonized data from 109,184 adults (aged 18-97 years) from the SALURBAL (Salud Urbana en America Latina/Urban Health in Latin America) project. Hypertension was assessed by self-report. Individual-, sub-city- and city-level education were used as proxies of socioeconomic status. All models were stratified by gender.
Higher individual-level education was associated with lower odds of hypertension among women (university education or higher versus lower than primary: odds ratio [OR] = 0.67, 95% confidence interval [CI] = 0.61-0.74) but higher odds among men (OR = 1.65; 95%CI 1.47-1.86), although in men an inverse association emerged when measured blood pressure was used (OR = 0.86; 95%CI 0.76-0.97). For both genders, living in sub-city areas with higher educational achievement was associated with higher odds of hypertension (OR per standard deviation [SD] = 1.07, 95%CI = 1.02-1.12; OR = 1.11 per SD, 95%CI = 1.05-1.18, for women and men, respectively). The association of city-level education with hypertension varied across countries. In Peru, there was an inverse association (higher city level education was associated with lower odds of hypertension) in women and men, but in other countries no association was observed. In addition, the inverse association of individual-level education with hypertension became stronger (in women) or emerged (in men) as city or sub-city education increased.
The social patterning of hypertension differs by gender and by the level of analysis highlighting the importance of context- and gender-sensitive approaches and policies to reduce the prevalence of hypertension in Latin America.
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Details
- Title
- Gender differences in the association of individual and contextual socioeconomic status with hypertension in 230 Latin American cities from the SALURBAL study: a multilevel analysis
- Creators
- Débora Moraes Coelho - Universidade Federal de Minas GeraisAmanda Cristina de Souza Andrade - Institute of Public Health, Federal University of Mato Grosso, Avenida Fernando Corrêa 2367, Cuiabá, 78060-900, BrazilUriel Moreira Silva - Universidade Federal de Minas GeraisMariana Lazo - Drexel University, Community Health and PreventionS Claire Slesinski - Drexel University, Urban Health CollaborativeAlex Quistberg - Drexel University, Environmental and Occupational HealthAna V Diez-Roux - Drexel UniversityAmélia Augusta de Lima Friche - Universidade Federal de Minas GeraisWaleska Teixeira Caiaffa - Belo Horizonte Observatory for Urban Health, Avenida Alfredo Balena 190, Belo Horizonte, 30130-100, Brazil
- Publication Details
- BMC public health, v 23(1), 1532
- Publisher
- Springer BMC
- Grant note
- Wellcome Trust K01 TW011782 / FIC NIH HHS [205177/Z/16/Z] / Wellcome Trust
- Resource Type
- Journal article
- Language
- English
- Academic Unit
- Urban Health Collaborative; Community Health and Prevention; Environmental and Occupational Health
- Web of Science ID
- WOS:001049782400005
- Scopus ID
- 2-s2.0-85167753711
- Other Identifier
- 991021860619304721
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- Collaboration types
- Domestic collaboration
- International collaboration
- Web of Science research areas
- Public, Environmental & Occupational Health