Abstract Body: Introduction. Perceived neighborhood problems (PNP), including concerns about dilapidation and safety, have been linked to elevated hypertension risk through chronic stress pathways. The Identity Vitality-Pathology framework proposes a novel modifiable identity-based resilience construct. Identity vitality, capturing inclusive self-concept, status-independent self-worth, and compassionate orientation, is theorized to buffer the health impact of social stressors by influencing stress appraisal. We hypothesized that identity vitality would mitigate the impact of PNP on hypertension.
Methods. Using 2025 data from 2,008 Black and White women and men in the HARI study, we employed logistic regressions to estimate the cross-sectional association between PNP and self-reported hypertension. Models, controlling for age, education, perceived social support, and financial strain, were stratified by the four race-gender groups. Interaction terms between PNP and identity vitality (both measured using validated scales) assessed whether the PNP-hypertension association varied by levels of identity vitality.
Results. Among Black women, the mean age=48.1 ± 5.5 and 32.4% were hypertensive; Black men, mean age=46.4 ± 8.3, 23.7% hypertensive; white women, mean age=50.7 ± 9.5, 28.4% hypertensive; and white men, mean age=47.2 ± 8.4, 29.8% hypertensive. Among those with the highest compared to lowest PNP, a 1-SD increase in identity vitality was associated with lower odds of hypertension in all groups except white men, although estimates were largest and most precise among Black women (adjusted odds ratio = 0.46, 95% CI= 0.23, 0.96).
Conclusion. We found that a novel construct of identity-based resilience, identity vitality, moderates the impact of PNP on hypertension, particularly among Black women. This evidence suggests opportunities for novel culturally tailored interventions to mitigate the increased risk of hypertension among subjugated populations living in disadvantaged neighborhoods.