Residential Racial Segregation, Socioeconomic Status, and Hypertension Risk in Black and White Americans: The REGARDS Prospective Cohort Study.

IF 5.3 1区 医学 Q1 CARDIAC & CARDIOVASCULAR SYSTEMS
Journal of the American Heart Association Pub Date : 2025-10-07 Epub Date: 2025-09-30 DOI:10.1161/JAHA.125.041339
Debora Kamin Mukaz, Andrew D Sparks, Timothy B Plante, Suzanne E Judd, George Howard, Virginia J Howard, Loni P Tabb, Lorraine T Dean, Mary Cushman
{"title":"Residential Racial Segregation, Socioeconomic Status, and Hypertension Risk in Black and White Americans: The REGARDS Prospective Cohort Study.","authors":"Debora Kamin Mukaz, Andrew D Sparks, Timothy B Plante, Suzanne E Judd, George Howard, Virginia J Howard, Loni P Tabb, Lorraine T Dean, Mary Cushman","doi":"10.1161/JAHA.125.041339","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>Black adults experience the highest hypertension burden of any racial group. It is unclear whether different dimensions of residential segregation have different relationships with hypertension risk for Black and White people, or whether socioeconomic status explains any of the relationships.</p><p><strong>Methods: </strong>We studied 6787 Black and White participants from the REGARDS (Reasons for Geographic And Racial Differences in Stroke) study, without prevalent hypertension and with follow-up for hypertension 9.4 years later. County-level segregation was defined using dissimilarity, isolation, and interaction indices. Associations between residential segregation indices and incident hypertension were estimated. Racial differences in associations and mediating effects of socioeconomic factors were assessed.</p><p><strong>Results: </strong>Risk ratios (RRs) of incident hypertension were 1.06 per SD higher isolation index (95% CI, 1.03-1.09) and 0.96 per SD higher interaction index (95% CI, 0.93-0.99). The dissimilarity index was not associated with hypertension risk. Neighborhood socioeconomic status explained 19% of the association between the isolation index and hypertension incidence. Although there were no statistically significant racial differences in associations, the isolation index was marginally associated with higher risk of hypertension in Black people only (RR, 1.05 [95% CI, 0.98-1.12]), and neighborhood socioeconomic status was a marginally significant mediator of that association (RR indirect effects, 0.993 [95% CI, 0.98-1.0004]).</p><p><strong>Conclusions: </strong>Findings indicated that living in racially segregated counties was associated with higher risk of hypertension, particularly for Black people. Higher neighborhood socioeconomic status may mitigate the negative effects of that aspect of residential segregation on hypertension development.</p>","PeriodicalId":54370,"journal":{"name":"Journal of the American Heart Association","volume":" ","pages":"e041339"},"PeriodicalIF":5.3000,"publicationDate":"2025-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Journal of the American Heart Association","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1161/JAHA.125.041339","RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2025/9/30 0:00:00","PubModel":"Epub","JCR":"Q1","JCRName":"CARDIAC & CARDIOVASCULAR SYSTEMS","Score":null,"Total":0}
引用次数: 0

Abstract

Background: Black adults experience the highest hypertension burden of any racial group. It is unclear whether different dimensions of residential segregation have different relationships with hypertension risk for Black and White people, or whether socioeconomic status explains any of the relationships.

Methods: We studied 6787 Black and White participants from the REGARDS (Reasons for Geographic And Racial Differences in Stroke) study, without prevalent hypertension and with follow-up for hypertension 9.4 years later. County-level segregation was defined using dissimilarity, isolation, and interaction indices. Associations between residential segregation indices and incident hypertension were estimated. Racial differences in associations and mediating effects of socioeconomic factors were assessed.

Results: Risk ratios (RRs) of incident hypertension were 1.06 per SD higher isolation index (95% CI, 1.03-1.09) and 0.96 per SD higher interaction index (95% CI, 0.93-0.99). The dissimilarity index was not associated with hypertension risk. Neighborhood socioeconomic status explained 19% of the association between the isolation index and hypertension incidence. Although there were no statistically significant racial differences in associations, the isolation index was marginally associated with higher risk of hypertension in Black people only (RR, 1.05 [95% CI, 0.98-1.12]), and neighborhood socioeconomic status was a marginally significant mediator of that association (RR indirect effects, 0.993 [95% CI, 0.98-1.0004]).

Conclusions: Findings indicated that living in racially segregated counties was associated with higher risk of hypertension, particularly for Black people. Higher neighborhood socioeconomic status may mitigate the negative effects of that aspect of residential segregation on hypertension development.

居住种族隔离、社会经济地位和美国黑人和白人高血压风险:REGARDS前瞻性队列研究
背景:黑人成年人的高血压负担是所有种族中最高的。目前尚不清楚居住隔离的不同维度是否与黑人和白人的高血压风险有不同的关系,或者社会经济地位是否解释了任何关系。方法:我们研究了6787名来自REGARDS(中风的地理和种族差异的原因)研究的黑人和白人参与者,他们没有普遍的高血压,并在9.4年后随访高血压。采用不相似性、隔离性和相互作用指数来定义县级隔离。估计了居住隔离指数与高血压发病率之间的关系。评估了种族差异的关联和社会经济因素的中介效应。结果:高血压事件的风险比(RRs)为1.06 / SD高隔离指数(95% CI, 1.03-1.09)和0.96 / SD高相互作用指数(95% CI, 0.93-0.99)。差异指数与高血压风险无关。社区社会经济地位解释了隔离指数与高血压发病率之间19%的关联。虽然没有统计学上显著的种族差异,但隔离指数仅与黑人高血压高风险相关(RR, 1.05 [95% CI, 0.98-1.12]),社区社会经济地位是该关联的边际显著中介(RR间接效应,0.993 [95% CI, 0.98-1.0004])。结论:研究结果表明,生活在种族隔离县的人患高血压的风险更高,尤其是黑人。较高的社区社会经济地位可能会减轻居住隔离对高血压发展的负面影响。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
求助全文
约1分钟内获得全文 求助全文
来源期刊
Journal of the American Heart Association
Journal of the American Heart Association CARDIAC & CARDIOVASCULAR SYSTEMS-
CiteScore
9.40
自引率
1.90%
发文量
1749
审稿时长
12 weeks
期刊介绍: As an Open Access journal, JAHA - Journal of the American Heart Association is rapidly and freely available, accelerating the translation of strong science into effective practice. JAHA is an authoritative, peer-reviewed Open Access journal focusing on cardiovascular and cerebrovascular disease. JAHA provides a global forum for basic and clinical research and timely reviews on cardiovascular disease and stroke. As an Open Access journal, its content is free on publication to read, download, and share, accelerating the translation of strong science into effective practice.
×
引用
GB/T 7714-2015
复制
MLA
复制
APA
复制
导出至
BibTeX EndNote RefMan NoteFirst NoteExpress
×
提示
您的信息不完整,为了账户安全,请先补充。
现在去补充
×
提示
您因"违规操作"
具体请查看互助需知
我知道了
×
提示
确定
请完成安全验证×
copy
已复制链接
快去分享给好友吧!
我知道了
右上角分享
点击右上角分享
0
联系我们:info@booksci.cn Book学术提供免费学术资源搜索服务,方便国内外学者检索中英文文献。致力于提供最便捷和优质的服务体验。 Copyright © 2023 布克学术 All rights reserved.
京ICP备2023020795号-1
ghs 京公网安备 11010802042870号
Book学术文献互助
Book学术文献互助群
群 号:604180095
Book学术官方微信