title: Association between neighborhood disadvantage and hypertension prevalence, awareness, treatment, and control in older adults: results from the University of Alabama at Birmingham Study of Aging.
abstract: OBJECTIVE
  We evaluated the effect of neighborhood disadvantage (ND) on older adults' prevalence, awareness, treatment, and control of hypertension.
  
  
  METHODS
  Data were from the University of Alabama at Birmingham Study of Aging, an observational study of 1000 community-dwelling Black and White Alabamians aged 65 years and older, in 1999 to 2001. We assessed hypertension prevalence, awareness, treatment, and control with blood pressure measurements and self-report data. We assessed ND with US Census data corresponding with participants' census tracts, created tertiles of ND, and fit models with generalized estimating equations via a logit link function with a binomial distribution. Adjusted models included variables assessing personal advantage and disadvantage, place-based factors, sociodemographics, comorbidities, and health behaviors.
  
  
  RESULTS
  Living in mid-ND (adjusted odds ratio [AOR] = 1.6; 95% confidence interval [CI] = 1.2, 2.1) and high-ND tertiles (AOR = 1.8; 95% CI = 1.3, 2.3) was associated with higher hypertension prevalence, and living in high-ND tertiles was associated with lower odds of controlled hypertension (AOR = 0.6; 95% CI = 0.4, 0.6). In adjusted models, ND was not associated with hypertension awareness or treatment.
  
  
  CONCLUSIONS
  These findings show that neighborhood environmental factors matter for hypertension outcomes and suggest the importance of ND for hypertension management in older adults.
authors.affiliation: At the time of the study, David R. Buys and Richard M. Allman were and Patricia Sawyer is with the Division of Gerontology, Geriatrics, and Palliative Care, Department of Medicine, School of Medicine, University of Alabama at Birmingham. Virginia J. Howard and Emily B. Levitan are with the Department of Epidemiology, School of Public Health, University of Alabama at Birmingham. Leslie A. McClure is with the Department of Biostatistics, School of Public Health, University of Alabama at Birmingham. Katie Crawford Buys is with the Department of Community Health, Systems, and Outcomes, School of Nursing, University of Alabama at Birmingham.
authors.forename: David R
authors.initials: DR
authors.lastname: Buys
authors.forename: Virginia J
authors.initials: VJ
authors.lastname: Howard
authors.forename: Leslie A
authors.initials: LA
authors.lastname: McClure
authors.forename: Katie Crawford
authors.initials: KC
authors.lastname: Buys
authors.forename: Patricia
authors.initials: P
authors.lastname: Sawyer
authors.forename: Richard M
authors.initials: RM
authors.lastname: Allman
authors.forename: Emily B
authors.initials: EB
authors.lastname: Levitan
mesh_terms: D000368:Aged; D000407:Alabama / Q000453:epidemiology; D015897:Comorbidity; D005260:Female; D015438:Health Behavior; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D006973:Hypertension / Q000453:epidemiology* / Q000517:prevention & control*; D008137:Longitudinal Studies; D008297:Male; D011204:Poverty Areas; D015995:Prevalence; D012307:Risk Factors; D012959:Socioeconomic Factors; D011795:Surveys and Questionnaires