Racial/ethnic residential segregation and self-reported high blood pressure among us-and foreign-born blacks in New York city

Abstract

Efforts to explain the excess burden of high blood pressure among blacks have emphasized individual- and neighborhood-level characteristics. However, few studies have examined the additional role of racial/ethnic residential segregation. Further, research exploring the role of residential segregation by nativity status has been limited. This study investigated the association between residential segregation and self-reported high blood pressure among US- and foreign-born blacks. Individual-level data obtained from the 2002 and 2005 New York City Community Health Survey (n¼4,952) was linked to 2000 US Census data, which was used to define racial/ethnic residential segregation, operationalized as Wong’s local index. Prevalence odds ratios (OR) and 95% confidence intervals (CI) were estimated using a multilevel logistic model controlling for individual- and arealevel covariates. The prevalence of high blood pressure for US-born blacks and foreign-born blacks was 36.1% and 29.8%, respectively. In the fully adjusted model, there was no evidence in support of an association between residential segregation and self-reported high blood pressure among USborn blacks. Older foreign-born blacks residing in highly segregated neighborhoods had a lower odds of reporting high blood pressure (OR: 0.59; 95% CI: 0.48, 0.74) compared to their counterparts residing in less segregated areas. The findings underscore the need to consider the differential impact of residential segregation by nativity status. Future studies should explore psychosocial mechanisms and features of specific neighborhood characteristics that are important for understanding the pathway between residential segregation and health.