Neighborhood Socioeconomic Disadvantage; Neighborhood Racial Composition; and Hypertension Stage, Awareness, and Treatment Among Hypertensive Black Men in New York City: Does Nativity Matter?
Neighborhood Socioeconomic Disadvantage; Neighborhood Racial Composition; and Hypertension Stage, Awareness, and Treatment Among Hypertensive Black Men in New York City: Does Nativity Matter?
复制标题
DOI：
10.1007/s40615-016-0289-x
复制
发表时间：
2017-10-01
影响因子：
3.9
通讯作者：
Ravenell, Joseph
中科院分区：
文献类型：
--
作者：
Cole, Helen;Duncan, Dustin T.;Ravenell, Joseph
目标 社区贫困和种族构成可能会导致高血压结果的种族差异。人们对不同城市黑人成年人的出生状况如何影响邻里社会环境的影响知之甚少。我们的目的是描述社区层面的社会人口因素对血压不受控制的美国和外国出生的黑人男性高血压结果的影响。设计我们对两项大型社区试验的基线数据进行了横断面分析，试验对象是 50 岁及以上的高血压黑人男性，并与 2012 年美国社区调查 5 年估计的人口普查数据相关联。我们将高度种族隔离的人口普查区域定义为 60% 或以上自认为是黑人的人口普查区域，将高贫困人口普查区域定义为 20% 或以上生活在贫困线以下的人口普查区域。使用多变量一般估计方程模型来测量社区特征与高血压阶段、高血压知晓率和治疗之间的关联，以产生调整患病率（aPR）。针对美国和外国出生的黑人分别运行模型。结果 1139 名参与者中，超过 64% 的人居住在黑人居民比例较高的人口普查区，超过 71% 的人居住在高度贫困的人口普查区。居住在黑人居民高度集中的社区的外国出生的黑人男性接受高血压治疗的可能性较小（aPR 0.44，95% CI 0.22-0.88），但这一结果不适用于美国出生的黑人男性。社区贫困与高血压结果之间没有显着关联。 结论 社区环境可能会影响高血压的治疗，这是控制高血压和降低高血压相关死亡率的最重要因素之一，特别是在外国博拉黑人男性中。
Objective Neighborhood-level poverty and racial composition may contribute to racial disparities in hypertension outcomes. Little is known about how the effects of neighborhood social environments may differ by nativity status among diverse urban Black adults. We aimed to characterize the influence of neighborhood-level socio-demographic factors on hypertension outcomes among US- and foreign-born Black men with uncontrolled blood pressure.Design We conducted a cross-sectional analysis of baseline data from two large community-based trials of hypertensive Black men aged 50 and over linked with census tract data from the 2012 American Community Survey 5-year estimates. We defined census tracts with high racial segregation as those where 60 % or more self-identified as Black and high-poverty census tracts as those where 20 % or more lived below the poverty line. Multivariable general estimating equation models were used to measure associations between neighborhood characteristics and stage of hypertension, hypertension awareness, and treatment to yield adjusted prevalence ratios (aPR). Models were run separately for US- and foreign-born Black men.Results Over 64 % of the 1139 participants lived in a census tract with a high percentage of Black residents and over 71 % lived in high-poverty census tracts. Foreign-born Black men living in neighborhoods with a high concentration of Black residents were less likely to be treated for their high blood pressure (aPR 0.44, 95 % CI 0.22-0.88), but this result did not hold for US-born Black men. There were no significant associations between neighborhood poverty and hypertension outcomes.Conclusions Neighborhood context may impact treatment for hypertension, one of the most important factors in hypertension control and decreasing hypertension-related mortality, particularly among foreign-bora Black men.