Relation between neighborhood median housing value and hypertension risk among black women in the United States

Objectives. We examined the relation between median housing value and hypertension risk among US Black women. Methods. We gathered data from the Black Women's Health Study, a prospective follow-up of 59000 Black women aged 21 to 69 years in 1995. Median housing value from US census data was used to measure neighborhood socioeconomic status. Cases of hypertension were identified through postal questionnaires mailed in 1997, 1999, and 2001. Clustered survival regression models were used to estimate incidence rate ratios. Results. During 180294 person-years of observation, 3780 cases of hypertension were reported. A significant inverse, graded association was found between median housing value and hypertension. The incidence rate ratio for women living in low median housing value neighborhoods relative to high was 1.29 (95% confidence interval = 1.14, 1.45) after adjustment for individual risk factors. The association was evident even at higher individual levels of income and education. Conclusions. Median housing value is inversely associated with hypertension in Black women, independent of individual risk factors. Lowering hypertension risk in Black women will require a greater understanding of the underlying social inequalities that adversely affect health.