Residential segregation, a geographical manifestation of structural racism, was a significant cause of racial and ethnic health disparities. Still, longitudinal research on the impact of segregation on cardiovascular health was few. Therefore, the effect of segregation on hypertension in a multiracial and multiethnic sample was investigated in the research and whether the local environment affects this association. Researchers used race and ethnicity stratified Cox models to examine the association between time-varying segregation and incident hypertension in 1,937 adults free of hypertension at baseline, using data from a diverse cohort of adults recruited from 6 sites across the United States 2 decades of follow-up. Participants were classified as living in segregated or nonsegregated neighborhoods using a spatially weighted approach. The study team employed a robust covariance matrix estimator to accommodate for clustering among neighborhoods and investigated effect measure modification by local social or physical environment.
Furthermore, 65.5% of non-Hispanic Black, 48.1% Chinese, and 53.7% Hispanic individuals acquired hypertension over 7.35 years. In segregated communities, Black and Hispanic inhabitants were more likely to achieve hypertension than residents in nonsegregated neighborhoods (hazard ratio [HR], 1.33; 95% CI, 1.09–1.62; Hispanic residents: HR, 1.33; 95% CI, 1.04–1.70). The neighborhood social environment dramatically changed the impact of segregation on hypertension among Black inhabitants. A better social environment was associated with a less noticeable effect of segregation on hypertension. The outcomes emphasized the significance of continuing research into the health effects of racial residential segregation while considering contextual neighborhood elements such as the social environment.
Source –www.ahajournals.org/doi/10.1161/JAHA.121.023084
