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

D.R. Buys, V.J. Howard, L.A. McClure, K.C. Buys, P. Sawyer, R.M. Allman and E.B. Levitan

American Journal of Public Health, 2015, vol. 105, issue 6, 1181-1188

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. © 2015, American Public Health Association Inc. All rights reserved.

Keywords: aged; attitude to health; comorbidity; female; health behavior; human; hypertension; longitudinal study; male; poverty; prevalence; questionnaire; risk factor; socioeconomics; United States, Aged; Alabama; Comorbidity; Female; Health Behavior; Health Knowledge, Attitudes, Practice; Humans; Hypertension; Longitudinal Studies; Male; Poverty Areas; Prevalence; Risk Factors; Socioeconomic Factors; Surveys and Questionnaires (search for similar items in EconPapers)
Date: 2015
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Persistent link: https://EconPapers.repec.org/RePEc:aph:ajpbhl:10.2105/ajph.2014.302048_0

DOI: 10.2105/AJPH.2014.302048

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