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Morenoff, Jeffrey, Ben Hansen, James S. House, David R. Williams, George A. Kaplan, and Haslyn E. Hunte. 2007. "Understanding Social Disparities in Hypertension Prevalence, Awareness, Treatment, and Control: The Role of Neighborhood Context." PSC Research Report No. 07-614. January 2007.
This study examines the role that residential neighborhoods may play in racial/ethnic and socioeconomic disparities in systolic (SBP) and diastolic (DBP) blood pressure, hypertension, and awareness, treatment, and control of hypertension. Between May 2001 and March 2003 we collected data, including direct assessments of SBP and DBP, on a probability sample of 3105 participants aged 18 and over living in 343 Chicago neighborhoods. We found that blacks and people with lower levels of education have significantly higher levels of SBP and higher rates of hypertension than their respective comparison groups (i.e., whites and people with 16 or more years of education), but that these disparities diminish and become statistically insignificant after adjusting for neighborhood context. Levels of SBP and DBP and the rate of hypertension were lower in more affluent/gentrified neighborhoods (i.e., places with a high level of residential turnover and with greater shares of people in their 20s and 30s and/or have 16 or more years of education and are in professional or managerial occupations), net of controls for a wide range individual- and neighborhood-level controls. Among people with hypertension, blacks were more likely than whites to be aware of their condition, but this difference was also explained by neighborhood factors: people living in more disadvantaged neighborhoods and neighborhoods with greater proportions of blacks were more likely to be aware of their hypertension. Among those being treated for hypertension, blacks were less likely than whites to have their condition under control, and controls for neighborhood context failed to explain this disparity. In sum, residential neighborhoods potentially play a large role in accounting for social disparities in high blood pressure and hypertension prevalence and, in a different way, awareness, but not in treatment for and control of hypertension.