Separate and unequal : a spatially comprehensive analysis of Black-White hypertension disparities across the United States
Introduction: It is estimated that hypertension accounts for 50% of the Black-white mortality disparity in the U.S. In seeking to explain this disparity, most studies highlight the role of racial residential segregation - an institutional mechanism designed to protect whites from social interaction with Blacks. Though research has unveiled a significant relationship between racial disparities in health and racial segregation, the socioeconomic characteristics of Black and white designated neighborhoods remain widely unaccounted and controlled for in disparities analysis. Objective: The objectives of this study were twofold: first, simultaneously capture the racial, spatial, and socioeconomic structure of the United States; second, control for neighborhood characteristics in the analysis of Black-white hypertension Methods: The Darden-Kamel Composite Socioeconomic Index and Index of Dissimilarity are used to simultaneously capture the racial, spatial, and socioeconomic structure of the U.S., and control for neighborhood characteristics. Analysis: A chi-square test of independence established the significance of the relationship between neighborhood high blood pressure (HBP) prevalence and neighborhood socioeconomic position (SEP). ANOVA and Tukey's HSD determined the significance of mean HBP prevalence difference across SEP. A two-proportion z test established the significance of Black-white hypertension proportional differences across SEP's 1 and 5. Finally, binomial regression coefficients at each level of SEP were compared to determine the significance of race/ethnicity a predictor of hypertension at each level of SEP. Results: After controlling for neighborhood SEP and adjusting for the interaction between race and sex predictors, regression analysis revealed that race/ethnicity is a statistically insignificant predictor of hypertension at each level of SEP.
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- In Collections
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Electronic Theses & Dissertations
- Copyright Status
- In Copyright
- Material Type
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Theses
- Authors
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Martin-Ikpe, Cordelia
- Thesis Advisors
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Darden, Joe T.
- Committee Members
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Canady, Reneé B.
Broman, Clifford
Vojnovic, Igor
- Date Published
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2022
- Subjects
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Geography
Public health
Hypertension
Ethnic groups--Diseases
Medical geography
Diseases--Economic aspects
Diseases
United States
- Program of Study
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Geography - Doctor of Philosophy
- Degree Level
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Doctoral
- Language
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English
- Pages
- v, 107 pages
- ISBN
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9798358493681
- Permalink
- https://doi.org/doi:10.25335/xfxb-rp35