Community Characteristics are Associated with Blood Pressure Levels in a Racially Integrated Community

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 lowincome 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.

Unequal Gain of Equal Resources across Racial Groups

“…The findings are robust and hold independent of setting, cohort, age group, psychosocial determinants, and health outcome. Other researchers have also reported similar findings 55 - 81 (see Table 2 ).…”

Who you are and where you live can determine how long you live: What nurses need to know about cardiovascular disease among low‐income urban‐dwelling minority communities

“…With nearly half of African Americans in the United States having some form of cardiovascular disease, (46% among men and 48% among women), they are more susceptible to experiencing frequent hospitalisations and premature death (American Heart Association, ; Cunningham et al., ). African Americans living in low‐income urban settings experience unique social challenges such as increased exposure to crime and environmental toxins, lack of resources and poor access to healthy foods in comparison with people not living in low‐income urban areas (Franco, Roux, Glass, Caballero, & Brancati, ; Gaskin et al., ; Samuel, Thorpe, Bower, & LaVeist, ). Studies and reports have highlighted prevalence, identified barriers to, and made recommendations for effective management of cardiovascular disease.…”