Unique data indicate Black residents have reduced hypertension risk in Los Angeles neighborhoods where there is high organizational participation

In this article, authors Sharp and Carpiano note that hypertension, or high blood pressure, is a major health concern that disproportionately affects Black adults compared to White and Latino adults in the United States. And in Los Angeles County, this disparity is even more pronounced, with Black residents having more than twice the rate of hypertension compared to White and Latino residents. While there is research about how individual factors like health behaviors, socioeconomic status, and stress contribute to these racial differences in hypertension, not much research has explored the role played by exposures to neighborhood factors like the presence of neighborhood watch, civic groups, and ethnic pride and organizations. In this article, Sharp and Carpiano analyzed data collected in the first two waves of the Los Angeles Family and Neighborhood Survey (L.A. FANS), a three-wave study of adults and children in over 2,000 households in Los Angeles County and of the neighborhoods in which they live. It was designed to enable research on neighborhoods themselves and on the effects of neighborhood social environments on households and individuals by collecting longitudinal data on neighborhoods, families, children, and on residential choice and neighborhood change. The first wave of L.A.FANS was fielded between 2000 and 2001, Wave 2 took place in 2006-2008, and Wave 3 occurred between 2011 and 2013. The authors accessed the data via restricted use agreement with Data Sharing for Demographic Research Project (DSDR).

Sharp and Carpiano noted that L.A. FANS provides a valuable source of data for researching the effects of neighborhood environments on health and well-being, allowing their analysis to focus specifically on two aspects of neighborhoods. One was organizational participation (involvement in local groups and associations) and the other was collective efficacy (social cohesion and willingness to intervene for the public good)–measures they created from unique survey items in the data. They also utilized restricted census tract identifiers that showed where each respondent lived, which allowed the authors to append Census 2000 and American Community Survey data from 2005–2009 to Waves 1 and 2 of L.A. FANS. They could then “construct measures of adults’ neighborhood and activity space racial/ethnic and socioeconomic exposures.” This allowed them to study exposures both where people live and across the spaces they spend time in on a routine basis, like the workplace, grocery store, place of worship, and healthcare. Other data they used in their analysis included a self-reported indicator of whether respondents had high blood pressure, as well as measures of race, household income, employment, health insurance, and length of residence.

Sharp and Carpiano found that living in neighborhoods with high levels of organizational participation was linked to lower likelihood of having hypertension. This beneficial effect was strongest for Black adults. The authors found that “Black residents who live in highly organized communities have a lower risk of being hypertensive by over 60 percent compared with living in neighborhoods with low levels of organizational involvement where the Black disadvantage in hypertension risk is at its widest.” In highly participatory neighborhoods, the racial gaps in hypertension were eliminated. The authors could explain almost one-fifth of the Black-White hypertension disparity by differences in the neighborhood social organization exposures of Black and White adults’ residential communities. Collective efficacy also appeared to reduce the Black-White disparity, although the effect was weaker. Overall, the findings suggest that efforts to foster social participation, connectedness, and civic engagement within neighborhoods could help reduce both hypertension prevalence and racial inequalities in this major cardiovascular risk factor.