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Study examines racial residential segregation and blood pressure in black adults

The JAMA Network Journals

If exposure to neighborhood-level racial residential segregation changes is that associated with changes in blood pressure in a group of black adults?

A new article published by JAMA Internal Medicine reports on a study by Kiarri N. Kershaw, Ph.D., of the Northwestern University Feinberg School of Medicine, Chicago, and coauthors that used data from a geographically diverse group of 2,280 black adults whose addresses were tracked over 25 years of follow-up.

The data were from participants in the Coronary Artery Risk Development in Young Adults (CARDIA) study, which was conducted in four locations (Birmingham, Ala., Chicago, Minneapolis and Oakland, Calif.) from 1985 to 1986 and participants were examined over 30 years of follow-up. Racial segregation was assessed using a statistic that included neighborhood racial composition and the racial composition of the surrounding area.

Among the 2,280 participants, 81.6 percent (1,861) were living in a high-segregation neighborhood; 12.2 percent (278) were living in a medium-segregation neighborhood; and 6.2 percent (141) were living in a low-segregation neighborhood. Almost all participants moved at least once during the follow-up and more than half had moved three or more times.

The authors report increases in neighborhood-level racial residential segregation were associated with small increases in systolic blood pressure (the top number).

Among those living in high-segregation neighborhoods at the start, reductions in exposure to neighborhood segregation were associated with decreases in systolic blood pressure of more than 1mm Hg. Changes in segregation levels were not associated with changes in diastolic blood pressure (the bottom number), according to the results.

The authors suggest their findings are largely driven by people moving. They acknowledge limitations of the study, including other unmeasured mitigating factors.

"Findings from our observational study suggest that social policies that minimize segregation, such as the opening of housing markets, may have meaningful health benefits, including the reduction of blood pressure," the article concludes.



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