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Observational Study
. 2015 Jun;105(6):1181-8.
doi: 10.2105/AJPH.2014.302048. Epub 2014 Oct 16.

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

David R Buys  1 , Virginia J Howard, Leslie A McClure, Katie Crawford Buys, Patricia Sawyer, Richard M Allman, Emily B Levitan
Affiliations
Observational Study

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

David R Buys et al. Am J Public Health. 2015 Jun.

Abstract

Objectives: We evaluated the effect of neighborhood disadvantage (ND) on older adults' prevalence, awareness, treatment, and control of hypertension.

Methods: Data were from the University of Alabama at Birmingham Study of Aging, an observational study of 1000 community-dwelling Black and White Alabamians aged 65 years and older, in 1999 to 2001. We assessed hypertension prevalence, awareness, treatment, and control with blood pressure measurements and self-report data. We assessed ND with US Census data corresponding with participants' census tracts, created tertiles of ND, and fit models with generalized estimating equations via a logit link function with a binomial distribution. Adjusted models included variables assessing personal advantage and disadvantage, place-based factors, sociodemographics, comorbidities, and health behaviors.

Results: Living in mid-ND (adjusted odds ratio [AOR] = 1.6; 95% confidence interval [CI] = 1.2, 2.1) and high-ND tertiles (AOR = 1.8; 95% CI = 1.3, 2.3) was associated with higher hypertension prevalence, and living in high-ND tertiles was associated with lower odds of controlled hypertension (AOR = 0.6; 95% CI = 0.4, 0.6). In adjusted models, ND was not associated with hypertension awareness or treatment.

Conclusions: These findings show that neighborhood environmental factors matter for hypertension outcomes and suggest the importance of ND for hypertension management in older adults.

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Figures

FIGURE 1—
FIGURE 1—
Description of analytic sample: The University of Alabama at Birmingham Study of Aging, central Alabama, 1999–2001.
See this image and copyright information in PMC

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