Neighborhood Context and Hypertension Outcomes Among Latinos in Chicago

• Published in: Journal of immigrant and minority health Vol. 14; no. 6; pp. 959 - 967
• Main Authors: Viruell-Fuentes, Edna A., Ponce, Ninez A., Alegría, Margarita
• Format: Journal Article
• Language: English
• Published: Boston Springer US 01.12.2012; Springer Nature B.V
• Subjects: Adult; Chicago - epidemiology; Comparative Law; Cross-Sectional Studies; Emigrants and Immigrants - statistics & numerical data; Female; Ghettos; Health; Health care; Health care access; Health care policy; Health disparities; Health services; Health Services Accessibility - statistics & numerical data; Hispanic Americans; Hispanic Americans - statistics & numerical data; Humans; Hypertension; Hypertension - diagnosis; Hypertension - epidemiology; Hypertension - ethnology; Hypertension - therapy; Immigrants; International & Foreign Law; Language; Latin American people; Logistic Models; Male; Medicine; Medicine & Public Health; Mental health; Mexican Americans; Mexicans; Middle Aged; Minority & ethnic groups; Neighborhoods; Neighbourhoods; Noncitizens; Obesity; Original Paper; Private International Law; Public Health; Residence Characteristics - statistics & numerical data; Residential Patterns; Socioeconomic Factors; Sociology; Studies; Whites; Chicago; United States > US; Chicago Illinois; Hypertension; Neighborhood effects; Access to care; Latinos; Enclaves; Immigrants
• ISSN: 1557-1912; 1557-1920
• DOI: 10.1007/s10903-012-9608-4

Although a health advantage in hypertension has been documented among Latinos, this advantage appears to be eroding. Of particular concern is the observation that Latinos are less likely to be screened and treated for hypertension and to having it controlled. Scholars have suggested that, above and beyond individual-level factors, neighborhood characteristics may be important predictors of health and health care. We analyzed 2001–2003 data from the Chicago Community Adult Health Study to examine (a) the relationship between the Latino and immigrant composition of neighborhoods in Chicago and several outcomes among Latinos: having hypertension, utilizing hypertension-related health care, and being treated for hypertension; and (b) whether there was a differential effect of neighborhood Latino/immigrant concentration by language of interview and nativity status. We controlled for additional neighborhood characteristics relevant to hypertension and to the availability and accessibility of health care resources. Neighborhoods with higher concentrations of immigrants and Latinos were associated with Latinos having lower odds of hypertension (OR = 0.60, p  = 0.03). However, among those with hypertension, our results point to deleterious effects on hypertension care (OR = 0.55, p  = 0.06) and treatment (OR = 0.54, p  = 0.04) associated with living in neighborhoods with higher concentrations of immigrants and Latinos. We detected no significant interaction effects between immigrant/Latino neighborhood composition and language of interview or being an immigrant in this sample. These results suggest that improving access to care for Latinos with hypertension requires enhanced placement of community clinics and other safety-net health centers in neighborhoods with higher proportions of immigrants and Latinos.