ArticleCirculation. Cardiovascular quality and outcomes2022
Examining Neighborhood Socioeconomic Status as a Mediator of Racial/Ethnic Disparities in Hypertension Control Across Two San Francisco Health Systems.
Article in Circulation. Cardiovascular quality and outcomes, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 13 papers, 1 of them a synthesis that pooled it.
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Who cites it
13 citing papers in PubMed, 1 synthesis or guideline pooled it, 19 citations in OpenAlex.
- The 2017 American College of Cardiology/American Heart Association Hypertension Guideline and Blood Pressure in Older Adults.American journal of preventive medicine · 2023Guideline
- The child opportunity index and its association with resting and exercising blood pressure in children: a Chicago metro area pilot study.Preventive medicine reports · 2026Article
- Renal cell carcinoma incidence and mortality in California: a population-based study of sociodemographic patterns and temporal trends from 1988 through 2019.Lancet regional health. Americas · 2026Article
- Greater Hypertension Risk among Foreign-born Adults: Examining the Roles of Language, Nativity, and Neighborhood Deprivation in an Ethnoracially Diverse U.S. Sample.Journal of racial and ethnic health disparities · 2026Article
- Championing Hypertension Remote Monitoring for Equity and Dissemination (CHARMED): A multi-site factorial randomized controlled trial protocol.Contemporary clinical trials · 2025Article
- Self-Measured Blood Pressure Monitoring in Primary Care: Retrospective Analysis from a Large US Healthcare System.Clinical epidemiology · 2025Article
- Adverse social determinants of health elevate uncontrolled hypertension risk: a cardio-oncology prospective cohort study.JNCI cancer spectrum · 2024Article
- Neighborhood-Level Disparities in Hypertension Prevalence and Treatment Among Middle-Aged Adults.JAMA network open · 2024Article
- Mediation Effect of Obesity on the Association of Socioeconomic Status with Blood Pressure in the Elderly Hypertensive Population.Nutrients · 2024Article
- Racial Inequities in the Control of Hypertension and the Explanatory Role of Residential Segregation: a Decomposition Analysis in the Brazilian Longitudinal Study of Adult Health (ELSA-Brasil).Journal of racial and ethnic health disparities · 2024Article
- Spatial clusters of extended-spectrum beta-lactamase-producing Escherichia coli causing community-onset bacteriuria due to repeat infections: cluster analysis from a large urban medical center, San Francisco, 2014-2020.Antimicrobial resistance and infection control · 2023Article
- Neighborhood Characteristics and Elevated Blood Pressure in Older Adults.JAMA network open · 2023Article
- Reducing ethnic and racial disparities by improving undertreatment, control, and engagement in blood pressure management with health information technology (REDUCE-BP) hybrid effectiveness-implementation pragmatic trial: Rationale and design.American heart journal · 2023Article
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Authors and funding
9 authors at 4 institutions in 1 country.
Funding
Abstract
backgroundA contextual understanding of hypertension control can inform population health management strategies to mitigate cardiovascular disease events. This retrospective cohort study links neighborhood-level data with patients' health records to describe racial/ethnic differences in uncontrolled hypertension and determine if and to what extent these differences are mediated by neighborhood socioeconomic status (nSES).
methodsWe conducted a mediation analysis using a sample of patients with hypertension from 2 health care delivery systems in San Francisco over 2 years (n=47 031). We used generalized structural equation modeling, adjusted for age, sex, and health care system, to estimate the contribution of nSES to disparities in uncontrolled hypertension between White patients and Black, Hispanic/Latino, and Asian patients, respectively. Sensitivity analysis removed adjustment for health care system.
resultsOver half the cohort (62%) experienced uncontrolled hypertension during the study period. Racial/ethnic groups showed substantial differences in prevalence of uncontrolled hypertension and distribution of nSES quintiles. Compared with White patients, Black, and Hispanic/Latino patients had higher adjusted odds of uncontrolled hypertension: odds ratio, 1.79 [95% CI, 1.67-1.91] and odds ratio, 1.38 [95% CI, 1.29-1.47], respectively and nSES accounted for 7% of the disparity in both comparisons. Asian patients had slightly lower adjusted odds of uncontrolled hypertension when compared with White patients: odds ratio, 0.95 [95% CI, 0.89-0.99] and the mediating effect of nSES did not change the direction of the relationship. Sensitivity analysis increased the proportion mediated by nSES to 11% between Black and White patients and 13% between Hispanic/Latino and White patients, but did not influence differences between Asian and White patients.
conclusionsAmong patients with hypertension in this study, nSES mediated a small proportion of racial/ethnic disparities in uncontrolled hypertension. Population health management strategies may be most effective by focusing on additional structural and interpersonal pathways such as racism and discrimination in health care settings.
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