Neighborhood Stressors and Race/Ethnic Differences in Hypertension Prevalence (The Multi-Ethnic Study of Atherosclerosis)
dc.contributor.author | Mujahid, Mahasin S. | |
dc.contributor.author | Diez Roux, Ana V. | |
dc.contributor.author | Cooper, RC | |
dc.contributor.author | Shea, Steven | |
dc.contributor.author | Williams, David R. | |
dc.date.accessioned | 2010-11-29T15:36:13Z | |
dc.date.available | 2010-11-29T15:36:13Z | |
dc.date.issued | 2010-09 | |
dc.identifier.citation | Am J Hypertens. 2010 Sep 16.[Epub ahead of print] <http://hdl.handle.net/2027.42/78329> | en_US |
dc.identifier.uri | https://hdl.handle.net/2027.42/78329 | |
dc.description.abstract | Background: The reasons for racial/ethnic disparities in hypertension (HTN) prevalence in the United States are poorly understood.Methods: Using data from the Multi-Ethnic Study of Atherosclerosis (MESA), we investigated whether individual- and neighborhood-level chronic stressors contribute to these disparities in cross-sectional analyses. The sample consisted of 2,679 MESA participants (45-84 years) residing in Baltimore, New York, and North Carolina. HTN was defined as systolic or diastolic blood pressure ≥140 or 90 mm Hg, or taking antihypertensive medications. Individual-level chronic stress was measured by self-reported chronic burden and perceived major and everyday discrimination. A measure of neighborhood (census tract) chronic stressors (i.e., physical disorder, violence) was developed using data from a telephone survey conducted with other residents of MESA neighborhoods. Binomial regression was used to estimate associations between HTN and race/ethnicity before and after adjustment for individual and neighborhood stressors.Results: The prevalence of HTN was 59.5% in African Americans (AAs), 43.9% in Hispanics, and 42.0% in whites. Age- and sex-adjusted relative prevalences of HTN (compared to whites) were 1.30 (95% confidence interval (CI): 1.22-1.38) for AA and 1.16 (95% CI: 1.04-1.31) for Hispanics. Adjustment for neighborhood stressors reduced these to 1.17 (95% CI: 1.11-1.22) and 1.09 (95% CI: 1.00-1.18), respectively. Additional adjustment for individual-level stressors, acculturation, income, education, and other neighborhood features only slightly reduced these associations.Conclusion: Neighborhood chronic stressors may contribute to race/ethnic differences in HTN prevalence in the United States.American Journal of Hypertension (2010). | en_US |
dc.format.extent | 415059 bytes | |
dc.format.mimetype | application/pdf | |
dc.language.iso | en_US | en_US |
dc.title | Neighborhood Stressors and Race/Ethnic Differences in Hypertension Prevalence (The Multi-Ethnic Study of Atherosclerosis) | en_US |
dc.type | Article | en_US |
dc.subject.hlbsecondlevel | Public Health | |
dc.subject.hlbtoplevel | Health Sciences | |
dc.contributor.affiliationum | Epidemiology, Department of | en_US |
dc.contributor.affiliationumcampus | Ann Arbor | en_US |
dc.description.bitstreamurl | http://deepblue.lib.umich.edu/bitstream/2027.42/78329/1/MujahidDiezRoux2010_AmJHTN.pdf | |
dc.owningcollname | Epidemiology, Department of (SPH) |
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