Journal article
Residential Racial Segregation, Socioeconomic Status, and Hypertension Risk in Black and White Americans: The REGARDS Prospective Cohort Study
Journal of the American Heart Association, v 14(19), e041339
30 Sep 2025
PMID: 41025450
Featured in Collection : UN Sustainable Development Goals @ Drexel
Abstract
Black adults experience the highest hypertension burden of any racial group. It is unclear whether different dimensions of residential segregation have different relationships with hypertension risk for Black and White people, or whether socioeconomic status explains any of the relationships.
We studied 6787 Black and White participants from the REGARDS (Reasons for Geographic And Racial Differences in Stroke) study, without prevalent hypertension and with follow-up for hypertension 9.4 years later. County-level segregation was defined using dissimilarity, isolation, and interaction indices. Associations between residential segregation indices and incident hypertension were estimated. Racial differences in associations and mediating effects of socioeconomic factors were assessed.
Risk ratios (RRs) of incident hypertension were 1.06 per SD higher isolation index (95% CI, 1.03-1.09) and 0.96 per SD higher interaction index (95% CI, 0.93-0.99). The dissimilarity index was not associated with hypertension risk. Neighborhood socioeconomic status explained 19% of the association between the isolation index and hypertension incidence. Although there were no statistically significant racial differences in associations, the isolation index was marginally associated with higher risk of hypertension in Black people only (RR, 1.05 [95% CI, 0.98-1.12]), and neighborhood socioeconomic status was a marginally significant mediator of that association (RR indirect effects, 0.993 [95% CI, 0.98-1.0004]).
Findings indicated that living in racially segregated counties was associated with higher risk of hypertension, particularly for Black people. Higher neighborhood socioeconomic status may mitigate the negative effects of that aspect of residential segregation on hypertension development.
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Details
- Title
- Residential Racial Segregation, Socioeconomic Status, and Hypertension Risk in Black and White Americans: The REGARDS Prospective Cohort Study
- Creators
- Debora Kamin Mukaz (Corresponding Author) - University of VermontAndrew D Sparks - University of VermontTimothy B Plante - University of VermontSuzanne E Judd - University of Alabama at BirminghamGeorge Howard - University of Alabama at BirminghamVirginia J Howard - University of Alabama at BirminghamLoni P Tabb - Drexel UniversityLorraine T Dean - Johns Hopkins UniversityMary Cushman - University of Vermont
- Publication Details
- Journal of the American Heart Association, v 14(19), e041339
- Publisher
- American Heart Association
- Number of pages
- 10
- Grant note
- National Institute of Neurological Disorders and Stroke: U01 NS041588 National Institute on Aging, National Institutes of Health, Department of Health and Human Service
This research project is supported by cooperative agreement U01 NS041588, cofunded by the National Institute of Neurological Disorders and Stroke and the National Institute on Aging, National Institutes of Health, Department of Health and Human Service. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institute of Neurological Disorders and Stroke or the National Institute on Aging. Representatives of the National Institute of Neurological Disorders and Stroke were involved in the review of the article but were not directly involved in the collection, management, analysis, or interpretation of the data. The authors thank the other investigators, the staff, and the participants of the REGARDS study for their valuable contributions. A full list of participating REGARDS investigators and institutions can be found at http://www.regardsstudy.org.
- Resource Type
- Journal article
- Language
- English
- Academic Unit
- Urban Health Collaborative; Epidemiology and Biostatistics
- Web of Science ID
- WOS:001589103500001
- Scopus ID
- 2-s2.0-105018023183
- Other Identifier
- 991022118672404721
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- Collaboration types
- Domestic collaboration
- Web of Science research areas
- Cardiac & Cardiovascular Systems