Segregated Neighborhoods Increase Heart Attack Risk for Black Americans: Study

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Previous research has shown that the longer people live in racially segregated neighborhoods, the worse their health becomes.

But new research published in JAMA Internal Medicine demonstrates how the problem is impacting one ethnic group in particular.

Credit: Johnny Silvercloud/Flickr, CC BY-SA 2.0

The study looked at 2,280 black volunteers aged 18 to 30 over a 25-year period. The subjects lived in Chicago, Birmingham, Ala., Oakland and Minneapolis. About 82 percent of them were living in neighborhoods deemed “highly segregated,” with 12.2 percent and 6.2 percent in medium and low segregation neighborhoods, respectively.

“Among those living in high-segregation neighborhoods at baseline, reductions in exposure to neighborhood segregation were associated with decreases in systolic blood pressure of more than 1 mm Hg,” the authors reported.

Despite the widely held belief that the systolic (top number) of a blood pressure reading is not that important, when it comes to African Americans 1 mm Hg can be a matter of life and death.

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“Reductions in systolic blood pressure of this magnitude could have important implications for reducing cardiovascular events, particularly in black individuals,” explained the authors, who hailed from the prestigious Northwestern University Feinberg School of Medicine in Chicago.

“Systolic blood pressure is more closely associated with incident cardiovascular events than diastolic blood pressure among middle-aged and older adults,” according to the paper, “and recent work in CARDIA showed that systolic blood pressure was associated with incident cardiovascular events in younger black adults as well.”

In fact, the authors said one recent study showed that a reduction of 1 mm Hg resulted in 10 fewer “coronary heart disease and stroke events and approximately 20 fewer heart failure events per 100,000 person-years in black individuals.”

Blacks Already at Higher Risk for Cardiovascular Disease

These findings are extra relevant because African Americans already are at greater risk of cardiovascular disease, high blood pressure, stroke and heart attack.

“The persistence of these findings after adjustment for neighborhood poverty, physical activity, body mass index, and smoking suggests that other factors may operate to link segregation and systolic blood pressure,” reported the authors.

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“Segregation affects the quality of schools, the value of housing, and the physical access to health-promoting resources (e.g. pharmacies, full-service grocers, and gyms),” they continued. “Improved access to these resources and opportunities for participants and their children could reduce stress and in turn systolic blood pressure.”

As for the phenomena of segregated neighborhoods themselves, the authors explain, “While largely thought to be caused by structural discrimination (e.g. in housing and lending markets) differential residential preferences by race are believed to play a role as well.”