ASPPH logo


Member Research & Reports

Member Research & Reports

Association between Neighborhood Disadvantage and Hypertension Investigated by UAB

Dr. Emily B. Levitan, associate professor in the department of epidemiology, and Dr. David R. Buys, adjunct assistant professor in the department of gerontology, geriatrics, and palliative care, at the University of Alabama at Birmingham—in collaboration with Dr. Patricia Sawyer, associate professor, and Dr. Richard M. Allman, professor emeritus, also in UAB’s department of gerontology, geriatrics, and palliative care; Dr. Virginia J. Howard, professor in the department of epidemiology; Dr. Leslie A. McClure, professor in the department of biostatistics; and Ms. Katie Crawford Buys, instructor in the school of nursing—recently evaluated the effect of neighborhood disadvantage on older adults’ prevalence, awareness, treatment, and control of hypertension.

[Photo: Dr. Emily B. Levitan]

Using data from the UAB Study of Aging—an observational study of 1,000 community-dwelling black and white Alabamians, ages 65 and older in 1999 to 2001—the researchers studied whether the neighborhoods where people live influence whether older adults have hypertension, whether they are aware of hypertension, and whether and how well their hypertension is treated. Neighborhood disadvantage was quantified using the neighborhood disadvantage index (NDI), which is a composite of the prevalence of poverty and the prevalence of female-headed households in the census tract of residence.

Results indicate that living in mid-NDI and high-NDI tertiles was associated with higher hypertension prevalence, and living in high-NDI tertiles was associated with lower odds of controlled hypertension after adjusting for personal advantage and disadvantage, place-based factors, socio-demographics, comorbidities, and health behaviors. In adjusted models, NDI was not associated with hypertension awareness or treatment. The team concluded that these findings show that neighborhood environmental factors matter for hypertension outcomes and suggest the importance of NDI for hypertension management in older adults.

“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” was published in October in the American Journal of Public Health.

Journal article: