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Neighborhood Context and Hypertension Outcomes Among Latinos in Chicago

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Abstract

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.

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Acknowledgments

This project was supported by a grant to E. A. Viruell-Fuentes from the Network for Multicultural Research on Health and Healthcare at the Department of Family Medicine, David Geffen School of Medicine, University of California at Los Angeles, with funding from the Robert Wood Johnson Foundation. N.A. Ponce received support from the National Cancer Institute (grant # K07CA100097). The Chicago Community Adult Health Study data collection was funded by grant #s P50HD38986 and R01HD050467 from the National Institute of Child Health and Human Development. The contents of this article are solely the responsibility of the authors and do not necessarily represent the official views of the NICHHD, NCI, or NIH. We thank Aggie Noah and Bryanna Mantilla for their research assistance.

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Authors and Affiliations

  1. Department of Latina/Latino Studies, University of Illinois at Urbana-Champaign, 510 E. Chalmers St., MC-495, Champaign, IL, 61820, USA

    Edna A. Viruell-Fuentes

  2. Department of Health Services, Fielding School of Public Health, University of California at Los Angeles, Los Angeles, CA, USA

    Ninez A. Ponce

  3. Harvard Medical School and Center for Multicultural Mental Health Research, Cambridge Health Alliance, Cambridge, MA, USA

    Margarita Alegría

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  1. Edna A. Viruell-Fuentes
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Correspondence to Edna A. Viruell-Fuentes.

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Viruell-Fuentes, E.A., Ponce, N.A. & Alegría, M. Neighborhood Context and Hypertension Outcomes Among Latinos in Chicago. J Immigrant Minority Health 14, 959–967 (2012). https://doi.org/10.1007/s10903-012-9608-4

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