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- Title
Association Between Neighborhood Disadvantage and Hypertension Prevalence, Awareness, Treatment, and Control in Older Adults: Results From the University of Alabama at Birmingham Study of Aging.
- Authors
Buys, David R.; Howard, Virginia J.; McClure, Leslie A.; Buys, Katie Crawford; Sawyer, Patricia; Allman, Richard M.; Levitan, Emily B.
- Abstract
Objectives. We e va luated th e e ffe c t o f n e ig h b o rh o o d d isa d van ta g e (ND) on o ld e r a d u lts ' prevalence, awareness, tre a tm e n t, and c o n tro l o f h yp e rte n s io n . Methods. Data w e re from th e U n iv e rs ity o f A la b am a at B irm in g h am S tu d y o f A g in g , an o b s e rv a tio n a l s tu d y o f 1000 c om m u n ity -dw e llin g Black and W h ite A la b am ia n s aged 65 years and o ld e r, in 1999 to 2001. We assessed h yp e rte n s io n prevalence, awareness, tre a tm e n t, and c o n tro l w ith b lo o d pressure measurem e n ts and se lf-re p o rt data. We assessed ND w ith US Census data c o rre s p o n d in g w ith participants' census tracts, created tertiles o f ND, and fit models w ith generalized estimating equations via a lo g it link function w ith a binomial distribution. Adjusted models included variables assessing personal advantage and disadvantage, placebased factors, sociodemographics, comorbidities, and health behaviors. Results. L iv in g in m id -N D (adjusted o dds ra tio [AOR] = 1.6; 95% co n fid e n ce in te rva l [Cl] = 1.2, 2.1) and h ig h -N D te rtile s (AOR = 1.8; 95% Cl = 1.3, 2.3) was associated w ith h ig h e r hype rte n s io n prevalence, and liv in g in high-ND te rtile s w as associated w ith low e r o dds o f co n tro lle d h yp ertens ion (AOR = 0.6; 95% Cl = 0.4, 0.6). In adjusted models, ND was n o t associated w ith h yp ertens ion awareness o r tre a tm e n t. Conclusions. These fin d in g s s h ow th a t n e ig h b o rh o o d e n v iro nm e n ta l fa c to rs matter for hypertension outcomes and suggest the importance of ND for hypertension management in older adults.
- Subjects
ALABAMA; HYPERTENSION &; psychology; HYPERTENSION; THERAPEUTICS; HYPERTENSION epidemiology; POVERTY areas; CHI-squared test; CONFIDENCE intervals; HEALTH behavior; POPULATION geography; RESEARCH funding; RESIDENTIAL patterns; SOCIOECONOMIC factors; SOCIAL context; DATA analysis software; HEALTH &; social status; STATISTICAL models; DESCRIPTIVE statistics; ODDS ratio; OLD age
- Publication
American Journal of Public Health, 2015, Vol 105, Issue 6, p1181
- ISSN
0090-0036
- Publication type
Article
- DOI
10.2105/AJPH.2014.302048