Abstract Body: Introduction: Prior research has linked low neighborhood social cohesion to increased cardiovascular disease (CVD) risk. However, the relationship between neighborhood social cohesion and incident hypertension, a major risk factor for CVD, has been understudied. Additionally, whether this association differs across racial and ethnic groups and by sex is unclear. This study examined the association between neighborhood social cohesion and incident hypertension among older adults, and whether this relationship varied across racial and ethnic groups, and sex.
Hypothesis: Low neighborhood social cohesion (versus high) will be associated with a higher risk of hypertension, and associations will vary by racial and ethnic groups, and sex within these groups.
Methods: Data were obtained from the US Health and Retirement Study (n=3,072 [85.1% Non-Hispanic (NH) White, 6.8% NH Black, 8.1% Hispanic], 39.9% male, 60.1% female, mean age=62.6 years [standard deviation=8.14]). Participants without hypertension and who completed the Neighborhood Social Cohesion Questionnaire at baseline (2006 or 2008) were observed at their 4- or 8-year follow-up visits for hypertension development (systolic blood pressure [BP] ≥140 mmHg, diastolic BP ≥90 mmHg, and/or antihypertensive medication use). Cox proportional hazards regression was used to estimate hazard ratios (HR) and 95% confidence intervals (CI). Interaction terms were included in models adjusted for sociodemographic and hypertension risk factors. Data were weighted to be nationally representative of the older adult US population.
Results: Overall, 59.2% of the study population developed hypertension (by racial and ethnic group: 38.9% NH White, 48.1% NH Black, 54.2% Hispanic participants). Low neighborhood social cohesion (versus high) was associated with increased risk for hypertension in the total study population (HR=2.39, 95% CI: 2.06-2.78). NH Black adults had the highest risk for hypertension (HR=3.70, 95% CI: 1.92-7.13), followed by Hispanic (HR=2.37, 95% CI: 1.44-3.91) and NH White (HR=2.28, 95% CI: 1.93-2.69) adults. These associations did not vary by sex within racial and ethnic groups.
Conclusions: Findings suggest that low neighborhood social cohesion may be a risk factor for hypertension development, particularly among older NH Black adults. These findings highlight the importance of developing neighborhood-level interventions to increase social interaction and sense of belonging to reduce hypertension risk.