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Community Characteristics are Associated with Blood Pressure Levels in a Racially Integrated Community
L J Samuel1, R J Thorpe, K M Bower
1Department of Epidemiology, Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD, USA, lsamuel@jhmi.edu.
Insights
Community characteristics impact blood pressure differently across racial groups in integrated neighborhoods. Greater community problems were linked to lower blood pressure in whites, while social cohesion was linked to higher blood pressure in African Americans.
Area of Science:
- Environmental Health
- Sociology
- Public Health
Background:
- Previous research linked community problems to higher blood pressure and resources/social cohesion to lower blood pressure.
- These associations may be confounded by residential racial segregation.
- Limited research exists on these factors within racially integrated communities.
Purpose of the Study:
- To examine associations between community characteristics and blood pressure levels in a racially integrated community.
- To investigate racial differences in these associations.
- To assess the impact of community problems, social cohesion, and resources on blood pressure and hypertension prevalence.
Main Methods:
- The study utilized data from the Exploring Health Disparities in Integrated Communities Study.
- Blood pressure was measured in residents of two contiguous, racially integrated, low-income US Census Tracts.
- Community characteristics included problem scores, social cohesion, leader availability, and resource proximity.
Main Results:
- Among white residents, greater community problems and proximity to resources were associated with lower systolic and diastolic blood pressure.
- Among African American residents, social cohesion was associated with higher systolic and diastolic blood pressure.
- Associations between community characteristics and blood pressure varied by race, with some findings differing from prior studies.
Conclusions:
- Community characteristics are associated with blood pressure levels in a racially integrated, low-income community.
- The direction of these associations differs by race, potentially due to exposure to adverse environmental conditions and risk factors.
- Findings highlight the complex interplay of race, community environment, and cardiovascular health.
Abstract:
Community problems have been associated with higher, and community resources and social cohesion with lower, blood pressure. However, prior studies have not accounted for potential confounding by residential racial segregation. This study tested associations between community characteristics and blood pressure levels and prevalent hypertension in a racially integrated community. The Exploring Health Disparities in Integrated Communities Study measured blood pressure in residents of two contiguous racially integrated and low-income US Census Tracts. Community characteristics included a standardized community problem score and binary indicators for community social cohesion, having a community leader available, and having at least one community resource observed on the participant's block. In adjusted models, greater community problems and proximity to resources were associated with lower systolic (β = -2.020, p = 0.028; β = -4.132, p = 0.010) and diastolic (β = -1.261, p = 0.038; β = -2.290, 0.031) blood pressure, respectively, among whites (n = 548). Social cohesion was associated with higher systolic (β = 4.905, p = 0.009) and diastolic blood pressure (β = 3.379, p = 0.008) among African Americans (n = 777). In one racially integrated low-income community, community characteristics were associated with blood pressure levels, and associations differed by race. Directions of associations for two findings differed from prior studies; greater community problem was associated with lower blood pressure in whites and community social cohesion was associated with higher blood pressure in African Americans. These findings may be due to exposure to adverse environmental conditions and hypertensive risk factors in this low-income community.
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