School Neighborhood Deprivation is Associated with a Higher Prevalence of Hypertension.

Abstract

Objectives: To examine the association between socioeconomic characteristics of school neighborhoods and the prevalence of hypertension in adolescents.

Study design: We performed a secondary data analysis of over 21,000 adolescents who participated in a school BP surveillance program between 2000 and 2017. BP status was confirmed by BP measurements on up to 3 occasions to diagnose sustained hypertension according to standard pediatric hypertension guidelines. We assessed school neighborhood socioeconomic status (SES) via the area deprivation index (ADI), a composite measure of area-level socioeconomic deprivation and categorized into quartiles. Q1 represented schools in neighborhoods with the least social deprivation while Q4 represented neighborhood with the most socioeconomic deprivation. We performed a cross-sectional analysis using both univariate and multivariable regression analyses.

Results: Of 21,392 children included in our analysis, the prevalence of sustained hypertension was 2.6%. Hispanics and African Americans were overrepresented in the schools in more deprived neighborhoods. The highest sustained hypertension rate was observed among students attending Q3 (5.5%) and Q4 (4.2%) schools compared to Q1 (2.7%) and Q2 (2.0%) schools (p < 0.001). Multivariable regression analysis showed that being male, obese, and attending school in a disadvantaged neighborhood were significantly associated with an increased prevalence of hypertension.

Conclusions: Our findings suggest that school neighborhood deprivation measured by ADI may be a risk factor for hypertension and may contribute to the racial/ ethnic disparities observed in hypertension prevalence in adolescents.