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J Appl Gerontol. 2016 Mar 22. pii: 0733464816638788. [Epub ahead of print]

Residential Segregation and Hypertension Prevalence in Black and White Older Adults.

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  • 1Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA.
  • 2Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA Johns Hopkins School of Nursing, Baltimore, MD, USA.
  • 3Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA



The purpose of this article was to assess segregation's role on race differences in hypertension among non-Hispanic Blacks and Whites aged 50 and over.


Hypertension was defined as systolic blood pressure (BP) ≥ 140 mmHg, diastolic BP ≥ 90 mmHg, or self-reported antihypertensive medication use. Segregation measures combined race, neighborhood racial composition, and individual and neighborhood poverty level. Logistic models produced odds ratios and 95% confidence intervals (CIs) for each segregation category, adjusting for health-related factors.


Blacks in Black (OR = 2.54, CI = [1.61, 4.00]), White (OR = 2.56, CI = [1.24, 5.31]), and integrated neighborhoods (OR = 3.23, CI = [1.72, 6.03]) had greater odds of hypertension compared with Whites in White neighborhoods. Poor Whites in poor neighborhoods (OR = 1.74, CI = [1.09, 2.76]), nonpoor Blacks in nonpoor (OR = 3.03, CI = [1.79, 5.12]) and poor neighborhoods (OR = 4.08, CI = [2.16, 7.70]), and poor Blacks in nonpoor (OR = 4.35, CI = [2.17, 8.73]) and poor neighborhoods (OR = 2.75, CI = [1.74, 4.36]) had greater odds compared with nonpoor Whites in nonpoor neighborhoods.


Interventions targeting hypertension among older adults should consider neighborhood compositions.


African American older adults; hypertension; neighborhoods; racial health disparities; segregation

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