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 When researchers looked at the “top number” known as systolic blood
pressure - the pressure blood exerts against artery walls when the
heart beats - they found moving away from segregated neighborhoods
mattered. Relocating to less segregated communities was associated
with average decreases of 1.2 to 1.3 mmHG (millimeters of mercury)
in systolic blood pressure.
“At the population level, a reduction of this magnitude is believed
to be sufficient to substantially reduce the occurrence of adverse
cardiovascular events like coronary heart disease, stroke, and heart
failure,” said lead study author Kiarri Kershaw of the Northwestern
University Feinberg School of Medicine in Chicago.
“These findings are important because they point to the important
role social policies can have in health,” Kershaw said by email.
In adults, 120/80 mmHG or lower is considered a normal or healthy
blood pressure.
For the current study, researchers followed 2,280 African-Americans
over more than two decades to see how switching neighborhoods
impacted blood pressure. When they joined the study in 1985 and 1986
participants lived in one of four U.S. cities: Chicago; Birmingham,
Alabama; Minneapolis; and Oakland, California.
Most of the participants, 82 percent, started out in highly
segregated communities. Another 12 percent lived in medium
segregation neighborhoods, and about 6 percent lived in low
segregation communities.
Then, researchers tracked residential moves by participants over 25
years of follow-up. Almost all participants moved at least once
during the study period, and more than half of them moved at least
three times.
Researchers didn’t find an association between neighborhood
segregation levels and the “bottom number” known as diastolic blood
pressure, which indicates how much pressure the blood exerts on
artery walls when the heart is at rest between beats.
The study wasn’t a controlled experiment designed to prove how
residential segregation may directly influence blood pressure or
make people sick.
Another limitation is that many participants dropped out during the
study, making it possible the results were influenced by certain
characteristics shared by people who stuck with it, the researchers
note in JAMA Internal Medicine.
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It’s also possible that some factors not measured in the study such
as participants’ housing priorities and preferences might have
influenced outcomes, the authors point out.
Still, the results support previous research suggesting that
neighborhoods can have a big influence on health, said David Chae,
director of the Center for Health Ecology and Equity Research at
Auburn University in Alabama.
“We have known for a very long time that some neighborhoods are
‘unhealthy,’ characterized by deficiencies, for example, in quality
health care, parks, recreational facilities and supermarkets,” Chae,
who wasn’t involved in the study, said by email. “Blacks are more
likely to live in areas with fewer opportunities to engage in
healthy behaviors and greater barriers to optimal health.”
Segregation was set up in many areas to ensure limited access to
certain types of employment, education and housing opportunities,
which ultimately resulted in various forms of unhealthy neighborhood
environments, said Asal Mohamadi Johnson, a public health researcher
at Stetson University in Florida who wasn’t involved in the study.
“Depending on what neighborhoods we live in, our exposure to social
and environmental determinants of health varies,” Johnson said by
email. “For instance, living in segregated or low income
neighborhoods could increase our chance of being exposed to
environmental pollutants, violence, or poor walking conditions.”
SOURCE: http://bit.ly/2qkyFO2 JAMA Internal Medicine, online May 15,
2017.
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