Original Paper

Journal of Behavioral Medicine

, Volume 37, Issue 1, pp 113-126

First online:

How neighborhood disorder increases blood pressure in youth: agonistic striving and subordination

  • Craig K. EwartAffiliated withDepartment of Psychology, Center for Health and Behavior, Syracuse University Email author 
  • , Gavin J. ElderAffiliated withDepartment of Psychology, Center for Health and Behavior, Syracuse University
  • , Joshua M. SmythAffiliated withDepartment of Psychology, Center for Health and Behavior, Syracuse UniversityDepartment of Biobehavioral Health, Pennsylvania State University

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Growing evidence links perceptions of neighborhood disorder to adverse health outcomes but little is known about psychological processes that may mediate this association. We tested the hypothesis that two psychological mechanisms—agonistic striving and subordination—mediate the link between perceived neighborhood disorder and hypertension risk in youth. Perceived neighborhood disorder, agonistic striving, subordination experiences, negative affect, obesity, and ambulatory blood pressure during daily activities (48 h) were assessed in a multiethnic sample of 167 low- to middle-income urban adolescents. Path analyses revealed that agonistic striving, subordination, and obesity each independently mediated the association between neighborhood disorder and blood pressure; these variables accounted for 73 % of the shared variance, 42 % of which was explained by agonistic striving. The direct relationship between perceived neighborhood disorder and blood pressure was no longer significant in the presence of these mediators. Negative affect was associated with neighborhood disorder and subordination, but not blood pressure. Agonistic striving proved to be a significant and substantial mediator of the association between perceived neighborhood disorder, blood pressure, and future hypertension risk. New research should seek to clarify the processes by which stressful neighborhoods induce persistent agonistic motives and perceptions of subordination in adolescents.


Adolescent health Perceived neighborhood disorder Agonistic striving Social power Subordination Implicit motives Hypertension risk