Journal article
Neighborhood Stressors and Race/Ethnic Differences in Hypertension Prevalence (The Multi-Ethnic Study of Atherosclerosis)
American journal of hypertension, v 24(2), pp 187-193
01 Feb 2011
PMID: 20847728
Featured in Collection : UN Sustainable Development Goals @ Drexel
Abstract
BACKGROUND
The reasons for racial/ethnic disparities in hypertension (HTN) prevalence in the United States are poorly understood.
METHODS
Using data from the Multi-Ethnic Study of Atherosclerosis (MESA), we investigated whether individual- and neighborhood-level chronic stressors contribute to these disparities in cross-sectional analyses. The sample consisted of 2,679 MESA participants (45-84 years) residing in Baltimore, New York, and North Carolina. HTN was defined as systolic or diastolic blood pressure >= 140 or 90 mm Hg, or taking antihypertensive medications. Individual-level chronic stress was measured by self-reported chronic burden and perceived major and everyday discrimination. A measure of neighborhood (census tract) chronic stressors (i.e., physical disorder, violence) was developed using data from a telephone survey conducted with other residents of MESA neighborhoods. Binomial regression was used to estimate associations between HTN and race/ethnicity before and after adjustment for individual and neighborhood stressors.
RESULTS
The prevalence of HTN was 59.5% in African Americans (AAs), 43.9% in Hispanics, and 42.0% in whites. Age- and sex-adjusted relative prevalences of HTN (compared to whites) were 1.30(95% confidence interval (CI): 1.22-1.38) for AA and 1.16(95% CI: 1.04-1.31) for Hispanics. Adjustment for neighborhood stressors reduced these to 1.17(95% CI: 1.11-1.22) and 1.99(95% CI: 1.00-1.18), respectively. Additional adjustment for individual-level stressors, acculturation, income, education, and other neighborhood features only slightly reduced these associations.
CONCLUSION
Neighborhood chronic stressors may contribute to race/ethnic differences in HTN prevalence in the United States.
Metrics
Details
- Title
- Neighborhood Stressors and Race/Ethnic Differences in Hypertension Prevalence (The Multi-Ethnic Study of Atherosclerosis)
- Creators
- Mahasin S. Mujahid - University of California, BerkeleyAna V. Diez Roux - University of MichiganRichard C. Cooper - College Station Medical CenterSteven Shea - Columbia UniversityDavid R. Williams - Harvard University
- Publication Details
- American journal of hypertension, v 24(2), pp 187-193
- Publisher
- Oxford Univ Press
- Number of pages
- 7
- Grant note
- P60 MD002249 / Michigan Center for Integrative Approaches to Health Disparities N01-HC-95159; N01-HC-95165; N01-HC-95169; R01 HL071759 / National Heart, Lung, and Blood Institute; United States Department of Health & Human Services; National Institutes of Health (NIH) - USA; NIH National Heart Lung & Blood Institute (NHLBI) R43HL095169 / NATIONAL HEART, LUNG, AND BLOOD INSTITUTE; United States Department of Health & Human Services; National Institutes of Health (NIH) - USA; NIH National Heart Lung & Blood Institute (NHLBI) P60MD002249 / National Institute on Minority Health and Health Disparities; United States Department of Health & Human Services; National Institutes of Health (NIH) - USA; NIH National Institute on Minority Health & Health Disparities (NIMHD) Robert Wood Johnson Foundation; Robert Wood Johnson Foundation (RWJF) N01HC095169 / DIVISION OF EPIDEMIOLOGY AND CLINICAL APPLICATIONS; United States Department of Health & Human Services; National Institutes of Health (NIH) - USA; NIH National Eye Institute (NEI)
- Resource Type
- Journal article
- Language
- English
- Academic Unit
- Urban Health Collaborative; Drexel University
- Web of Science ID
- WOS:000286451600011
- Scopus ID
- 2-s2.0-78751620015
- Other Identifier
- 991020112082204721
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- Collaboration types
- Domestic collaboration
- Web of Science research areas
- Peripheral Vascular Disease