Abstract MP81: Community Characteristics Are Associated With Blood Pressure Levels in a Racially Integrated Community
Some community characteristics, such as perceived problems, have been associated with higher blood pressure levels, while access to community resources and community social cohesion have been associated with lower blood pressure levels. However, potential confounding by residential racial segregation has previously been ignored, despite positive correlations between segregation and hypertension. This study tests the hypothesis that results differ in a racially integrated community.
Blood pressure was measured as the average of three readings from 1326 black and white adults residing in two racially integrated, contiguous, low income, urban US Census Tracts. Hypertension was defined as systolic BP≥140 mmHg and/or diastolic BP≥90 mmHg or use of antihypertensive medication(s). Neighborhood problems were measured with 15 questions about lack of resources, safety and crime. Participants were asked if people work together to solve problems to measure social cohesion and if the neighborhood has a leader. The presence of any desirable community resources on the participant’s block was also observed. Regression models were racially stratified because the effect of residential integration likely differs by race.
Perceptions of community problems and social cohesion and rates of community resources did not differ by race. Models adjusted for all community characteristics, age, sex, income, marital status, residency length, and in blood pressure models, antihypertensive medication use. In whites, each standard deviation increase in community problems was associated with lower systolic (β =-2.312, p=0.011) and diastolic (β =-1.484, p=0.014) blood pressure levels. Also, whites living on blocks with community resources had lower systolic (β=-4.079, p=0.011) and diastolic (β=-2.251, p=0.034) blood pressure levels and a lower likelihood of hypertension (PR=0.83, 95% CI: 0.73, 0.93), compared with whites lacking such resources. In African Americans, community social cohesion was associated with higher systolic (β =4.923, p=0.008) and diastolic (β=3.397, p=0.008) blood pressure levels. No associations were found for reporting a community leader. Results were unchanged after additional adjustment for behavioral variables.
Despite a shared community environment, perceptions of the community varied and some were associated with blood pressure levels, but not prevalent hypertension. Directions of associations oppose those of prior studies. This may be due to adverse features of this low income setting, which may contribute to hypertensive disparities. Closer proximity to community resources was associated with lower blood pressure levels and prevalent hypertension in whites. In conclusion, in this racially integrated and low income urban community, some community characteristics were associated with blood pressure levels, though some results differ from prior studies.
Author Disclosures: L.J. Samuel: None. R.J. Thorpe: None. T.A. LaVeist: None.
- © 2015 by American Heart Association, Inc.