Black and Hispanic adults who live in racially segregated neighborhoods may be more likely to develop high blood pressure than their peers who live in nonsegregated communities, a new study shows. The same was not true for Chinese adults.
But the gap begins to close if people in those segregated neighborhoods feel safe and socially connected to one another, researchers found. The findings were published Thursday in the Journal of the American Heart Association.
"The chronic stress from living in a segregated neighborhood with limited access to services, education and economic opportunities can increase the risk of hypertension," said lead study author Mahasin Mujahid, an associate professor of epidemiology at the University of California School of Public Health in Berkeley. "But a positive social environment can be beneficial in reducing that chronic stress."
High blood pressure, also called hypertension, is a major risk factor for heart attacks, strokes and other health issues, including dementia. In the U.S., hypertension rates among Black adults are among the highest in the world, affecting more than half of both men and women. And while Hispanic and Asian adults are less likely than their white counterparts to develop high blood pressure, they also are less likely to get blood pressure under control once hypertension sets in.
Previous research shows segregation plays a significant role in creating health disparities among racial and ethnic groups. Segregation is the result of past and present discriminatory policies based on race, such as mortgage redlining, urban renewal and systemic barriers to educational and economic opportunities. The associated lack of investment in predominantly Black and Hispanic neighborhoods often results in places with fewer safe places to play and walk and less access to fresh foods and produce, said Mujahid, "which impacts diet and physical activities and increases blood pressure."
In the new study, researchers tracked the development of hypertension over an average seven years of follow-up among 1,937 Black, Hispanic and Chinese adults. Participants were in their mid-to-late 50s, living in segregated and nonsegregated neighborhoods in six U.S. cities. By the end of the study, 66% of Black, 54% of Hispanic and 48% of Chinese participants had high blood pressure, which the researchers defined as a reading of at least 140/90 or taking blood pressure-lowering medication.
Black and Hispanic residents of segregated neighborhoods were 33% more likely to develop high blood pressure than their peers who lived in nonsegregated neighborhoods. They found no statistically significant difference in hypertension risk among Chinese adults living in segregated versus nonsegregated neighborhoods, which researchers said possibly was due to the small number of Chinese participants.
For Black residents of segregated neighborhoods, but not for Hispanic residents, that risk was somewhat lower when they reported a positive social environment. This included factors such as the aesthetic quality of the neighborhood, how safe people felt and whether they had good relationships with their neighbors. The more positive aspects the social environment included, the lower the residents' chances of developing high blood pressure.
"The pattern of racial segregation we see today was produced by policies that prevented Black, Hispanic, Asian and Indigenous people from buying or owning homes, attending high-quality schools, and pursuing economic opportunities in well-resourced, predominantly white neighborhoods," Mujahid said. "To cope with these oppressive limitations, minoritized communities frequently developed internal support systems to take care of each other."
For example, in neighborhoods where people are more socially connected, neighbors may ...
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