142nd APHA Annual Meeting and Exposition

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Association of perceived neighborhood social cohesion and hypertension in US South Asians: The Mediators of Atherosclerosis in South Asians Living in America Study

142nd APHA Annual Meeting and Exposition (November 15 - November 19, 2014): http://www.apha.org/events-and-meetings/annual
Tuesday, November 18, 2014 : 10:50 AM - 11:10 AM

Namratha Kandula, MD, MPH , Department of General Internal Medicine, Northwestern University, Chicago, IL
Ming Wen, PhD , Sociology, University of Utah, Salt Lake City, UT
Alka Kanaya, MD , Division of General Internal Medicine, University of California, San Francisco, San Francisco, CA
Background: Individuals of South Asian (India, Pakistan, Bangladesh, Sri Lanka, and Nepal) origin are the second fastest growing racial/ethnic group in the United States (US) and suffer from a high prevalence of cardiovascular disease and risk factors. We examined the association between perceptions of neighborhood social cohesion and hypertension among South Asian immigrants in the United States (US).

Methods:   The sample consisted of 906 South Asians, ages 40-84 years, who participated in the Mediators of Atherosclerosis in South Asians Living in America (MASALA) study from 2010-2013. Hypertension was defined as a blood pressure ≥140/90 or use of anti-hypertensive drug. Perceived neighborhood social cohesion was calculated from a validated scale of 5 items, higher values indicating greater cohesion. We performed multivariate logistic regression analysis to investigate the association of perceived neighborhood social cohesion with hypertension, independent of established risk factors and other psychosocial factors.

Results: The prevalence of hypertension was 45% in South Asian men and 36% in South Asian women. For women, higher neighborhood social cohesion had an inverse association with hypertension (OR=0.77; 95% CI: 0.60-0.99; p=0.04), independent of established risk factors (age, waist circumference, diabetes, and exercise) and of socioeconomic and psychosocial mediators such as income, education, social support, and chronic stress burden.  In South Asian men, perceived neighborhood social cohesion was not associated with hypertension.

Conclusion: In addition to established risk factors, higher perceived neighborhood social cohesion was associated with lower hypertension prevalence in South Asian women, but not in men. Further investigation is needed to understand the potential pathways connecting perceptions of neighborhood cohesion, hypertension, and cardiovascular risk in US South Asians.

Learning Areas:

Chronic disease management and prevention
Diversity and culture
Epidemiology
Social and behavioral sciences

Learning Objectives:
Describe the association of perceived neighborhood social cohesion and hypertension in South Asian immigrants living in the United States.

Keyword(s): Hypertension, Asian Americans

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I am a clinician research with expertise in epidemiology and South Asian health. I am the Principal Investigator of the Chicago Field Center for the MASALA study.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.

Back to: 4126.0: Social, Geographic and Individual Factors associated with Cardiovascular Risk and Disease