Journal
SOCIAL SCIENCE & MEDICINE
Volume 67, Issue 10, Pages 1604-1611Publisher
PERGAMON-ELSEVIER SCIENCE LTD
DOI: 10.1016/j.socscimed.2008.07.002
Keywords
Racial disparities; Hypertension; Residential segregation; Confounding race and socioeconomic status (SES); Integrated community; USA
Funding
- NIA NIH HHS [T32 AG000120, T32AG000120] Funding Source: Medline
- NIMHD NIH HHS [P60 MD000214, P60MD000214-01] Funding Source: Medline
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Disparities in hypertension between African Americans and non-Hispanic whites have been well-documented, yet an explanation for this persistent disparity remains elusive. Since African Americans and non-Hispanic white Americans tend to live in very different social environments, it is not known whether race disparities in hypertension would persist if non-Hispanic whites and African Americans were exposed to similar social environments. We compared data from the Exploring Health Disparities in Integrated Communities-SWB (EHDIC-SWB) Study with the National Health and Nutrition Examination Survey (NHANES) 1999-2004 to determine if race disparities in hypertension in the USA were attenuated in EHDIC-SWB, which is based in a racially integrated community without race differences in income. Hypertension was defined as systolic blood pressure (BP) >= 140 mmHg (millimeters of mercury) and/or diastolic BP >= 90 mmHg or respondent's report of taking antihypertensive medications. Of the 1408 study participants, 835 (59.3%) were African American, 628 (44.6%) were men, and the mean age was 40.6 years. After adjustment for potential confounders, various analytic models from EHDIC-SWB and NHANES 1999-2004 data, we found the race odds ratio was between 29.0% and 34% smaller in the EHDIC-SWB sample. We conclude that social and environmental exposures explained a substantial proportion of the race difference in hypertension. (c) 2008 Elsevier Ltd. All rights reserved.
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