Associations Between Residential Segregation and Incident Hypertension: The Multi-Ethnic Study of Atherosclerosis.
health equity
hypertension
neighborhood environment
racial residential segregation
Journal
Journal of the American Heart Association
ISSN: 2047-9980
Titre abrégé: J Am Heart Assoc
Pays: England
ID NLM: 101580524
Informations de publication
Date de publication:
02 2022
02 2022
Historique:
pubmed:
21
1
2022
medline:
9
4
2022
entrez:
20
1
2022
Statut:
ppublish
Résumé
Background Residential segregation, a geospatial manifestation of structural racism, is a fundamental driver of racial and ethnic health inequities, and longitudinal studies examining segregation's influence on cardiovascular health are limited. This study investigates the impact of segregation on hypertension in a multiracial and multiethnic cohort and explores whether neighborhood environment modifies this association. Methods and Results Leveraging data from a diverse cohort of adults recruited from 6 sites in the United States with 2 decades of follow-up, we used race- and ethnicity-stratified Cox models to examine the association between time-varying segregation with incident hypertension in 1937 adults free of hypertension at baseline. Participants were categorized as residing in segregated and nonsegregated neighborhoods using a spatial-weighted measure. We used a robust covariance matrix estimator to account for clustering within neighborhoods and assessed effect measure modification by neighborhood social or physical environment. Over an average follow-up of 7.35 years, 65.5% non-Hispanic Black, 48.1% Chinese, and 53.7% Hispanic participants developed hypertension. Net of confounders, Black and Hispanic residents in segregated neighborhoods were more likely to develop hypertension relative to residents in nonsegregated neighborhoods (Black residents: hazard ratio [HR], 1.33; 95% CI, 1.09-1.62; Hispanic residents: HR, 1.33; 95% CI, 1.04-1.70). Results were similar but not significant among Chinese residents (HR, 1.20; 95% CI, 0.83-1.73). Among Black residents, neighborhood social environment significantly modified this association such that better social environment was associated with less pronounced impact of segregation on hypertension. Conclusions This study underscores the importance of continued investigations of groups affected by the health consequences of racial residential segregation while taking contextual neighborhood factors, such as social environment, into account.
Identifiants
pubmed: 35048712
doi: 10.1161/JAHA.121.023084
pmc: PMC9238487
doi:
Types de publication
Journal Article
Research Support, N.I.H., Extramural
Langues
eng
Sous-ensembles de citation
IM
Pagination
e023084Subventions
Organisme : NHLBI NIH HHS
ID : N01 HC095163
Pays : United States
Organisme : NHLBI NIH HHS
ID : 75N92020D00005
Pays : United States
Organisme : NHLBI NIH HHS
ID : N01 HC095168
Pays : United States
Organisme : NHLBI NIH HHS
ID : 75N92020D00001
Pays : United States
Organisme : NHLBI NIH HHS
ID : N01 HC095162
Pays : United States
Organisme : NCATS NIH HHS
ID : UL1 TR001420
Pays : United States
Organisme : NHLBI NIH HHS
ID : N01 HC095169
Pays : United States
Organisme : NHLBI NIH HHS
ID : N01 HC095159
Pays : United States
Organisme : NHLBI NIH HHS
ID : N01 HC095161
Pays : United States
Organisme : NHLBI NIH HHS
ID : 75N92020D00004
Pays : United States
Organisme : NHLBI NIH HHS
ID : 75N92020D00007
Pays : United States
Organisme : NHLBI NIH HHS
ID : HHSN268201500003I
Pays : United States
Organisme : NHLBI NIH HHS
ID : N01 HC095166
Pays : United States
Organisme : NCATS NIH HHS
ID : UL1 TR001079
Pays : United States
Organisme : NHLBI NIH HHS
ID : N01 HC095167
Pays : United States
Organisme : NHLBI NIH HHS
ID : N01 HC095164
Pays : United States
Organisme : NHLBI NIH HHS
ID : N01 HC095160
Pays : United States
Organisme : NHLBI NIH HHS
ID : 75N92020D00002
Pays : United States
Organisme : NHLBI NIH HHS
ID : HHSN268201500003C
Pays : United States
Organisme : NHLBI NIH HHS
ID : N01 HC095165
Pays : United States
Organisme : NHLBI NIH HHS
ID : 75N92020D00003
Pays : United States
Organisme : NHLBI NIH HHS
ID : 75N92020D00006
Pays : United States
Organisme : NCATS NIH HHS
ID : UL1 TR000040
Pays : United States
Commentaires et corrections
Type : CommentIn
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