Journal article
Neighborhood characteristics and hypertension
Epidemiology (Cambridge, Mass.), v 19(4), pp 590-598
01 Jul 2008
PMID: 18480733
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Abstract
Background: 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.
Methods: 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.
Results: 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.
Conclusion: Neighborhood walkability, food availability, safety, and social cohesion may be mechanisms that link neighborhoods to hypertension.
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Details
- Title
- Neighborhood characteristics and hypertension
- Creators
- Mahasin S. Mujahid - University of MichiganAna V. Diez Roux (Corresponding Author) - University of MichiganJeffrey D. Morenoff - University of MichiganTrivellore E. Raghunathan - BiostatRichard S. Cooper - Loyola University ChicagoHanyu Ni - National Institutes of HealthSteven Shea - Columbia University
- Publication Details
- Epidemiology (Cambridge, Mass.), v 19(4), pp 590-598
- Publisher
- Lippincott Williams & Wilkins
- Number of pages
- 9
- Grant note
- R01HL071759 / 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) N01HC095159 / 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
- Epidemiology and Biostatistics
- Web of Science ID
- WOS:000256865100015
- Scopus ID
- 2-s2.0-49849090946
- Other Identifier
- 991020100088204721
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- Collaboration types
- Domestic collaboration
- Web of Science research areas
- Public, Environmental & Occupational Health