Journal article
Racial Inequities in the Control of Hypertension and the Explanatory Role of Residential Segregation: a Decomposition Analysis in the Brazilian Longitudinal Study of Adult Health (ELSA-Brasil)
Journal of racial and ethnic health disparities, v 11(2), pp 1024-1032
Apr 2024
PMID: 37052798
Featured in Collection : UN Sustainable Development Goals @ Drexel
Abstract
The mechanisms underlying racial inequities in uncontrolled hypertension have been limited to individual factors. We investigated racial inequities in uncontrolled hypertension and the explanatory role of economic segregation in the Brazilian Longitudinal Study of Adult Health (ELSA-Brasil). All 3897 baseline participants with hypertension (2008-2010) were included. Uncontrolled hypertension (SBP ≥ 140 mmHg or DBP ≥ 90 mmHg), self-reported race (White/Brown/Black people), and neighborhood economic segregation (low/medium/high) were analyzed cross-sectionally. We used decomposition analysis, which describes how much a disparity would change (disparity reduction; explained portion) and remain (disparity residual; unexplained portion) upon removing racial differences in economic segregation (i.e., if Black people had the distribution of segregation of White people, how much we would expect uncontrolled hypertension to decrease among Black people). Age- and gender-adjusted prevalence of uncontrolled hypertension (39.0%, 52.6%, and 54.2% for White, Brown, and Black participants, respectively) remained higher for Black and Brown vs White participants, regardless of economic segregation. Uncontrolled hypertension showed a dose-response pattern with increasing segregation levels for White but not for Black and Brown participants. After adjusting for age, gender, education, and study center, unexplained portion (disparity residual) of race on uncontrolled hypertension was 18.2% (95% CI 13.4%; 22.9%) for Black vs White participants and 12.6% (8.2%; 17.1%) for Brown vs White participants. However, explained portion (disparity reduction) through economic segregation was - 2.1% (- 5.1%; 1.3%) for Black vs White and 0.5% (- 1.7%; 2.8%) for Brown vs White participants. Although uncontrolled hypertension was greater for Black and Brown vs White people, racial inequities in uncontrolled hypertension were not explained by economic segregation.
Metrics
Details
- Title
- Racial Inequities in the Control of Hypertension and the Explanatory Role of Residential Segregation: a Decomposition Analysis in the Brazilian Longitudinal Study of Adult Health (ELSA-Brasil)
- Creators
- Joanna M N Guimarães - Fundação Oswaldo CruzJohn W Jackson - Johns Hopkins UniversitySharrelle Barber - Drexel UniversityRosane H Griep - Fundação Oswaldo CruzMaria de J M da Fonseca - Fundação Oswaldo CruzLidyane V Camelo - Universidade Federal de Minas GeraisSandhi M Barreto - Universidade Federal de Minas GeraisMaria Inês Schmidt - Universidade Federal do Rio Grande do SulBruce B Duncan - Universidade Federal do Rio Grande do SulLeticia de O Cardoso - Fundação Oswaldo CruzAlexandre C Pereira - University of Sao PauloDora Chor - Fundação Oswaldo Cruz
- Publication Details
- Journal of racial and ethnic health disparities, v 11(2), pp 1024-1032
- Publisher
- Springer Nature
- Number of pages
- 9
- Grant note
- HL145320 / NHLBI NIH HHS Finance code 001 / Coordination for the Improvement of Higher Education Personnel 01 06 0010.00 RS / Brazilian Ministry of Health and Ministry of Science, Technology and Innovation 01 06 0115.00 SP / Brazilian Ministry of Health and Ministry of Science, Technology and Innovation 01 06 0071.00 RJ / Brazilian Ministry of Health and Ministry of Science, Technology and Innovation 01 06 0212.00 BA / Brazilian Ministry of Health and Ministry of Science, Technology and Innovation 01 06 0300.00 ES / Brazilian Ministry of Health and Ministry of Science, Technology and Innovation 01 06 0278.00 MG / Brazilian Ministry of Health and Ministry of Science, Technology and Innovation
- Resource Type
- Journal article
- Language
- English
- Academic Unit
- Urban Health Collaborative
- Web of Science ID
- WOS:000983731300002
- Scopus ID
- 2-s2.0-85152789620
- Other Identifier
- 991020404288104721
UN Sustainable Development Goals (SDGs)
This publication has contributed to the advancement of the following goals:
InCites Highlights
Data related to this publication, from InCites Benchmarking & Analytics tool:
- Collaboration types
- Domestic collaboration
- International collaboration
- Web of Science research areas
- Public, Environmental & Occupational Health