School neighborhood deprivation is associated with a higher prevalence of hypertension

Authors: ONUGHA, ELIZABETH - Baylor College Of Medicine; BANERJEE, ANKONA - Baylor College Of Medicine; NOBLEZA, KENNETH - Baylor College Of Medicine; NGUYEN, DUC - Baylor College Of Medicine; ROSALES, OMAR - Baylor College Of Medicine; OLUYOMI, ABIODUN - Baylor College Of Medicine; DAVE, JAYNA - Children'S Nutrition Research Center (CNRC); SAMUELS, JOSHUA - Non ARS Employee

Submitted to: Annals Of Epidemiology
Publication Type: Peer Reviewed Journal
Publication Acceptance Date: 1/28/2025
Publication Date: 1/31/2025
Citation: Onugha, E.A., Banerjee, A., Nobleza, K.J., Nguyen, D.T., Rosales, O., Oluyomi, A., Dave, J.M., Samuels, J. 2025. School neighborhood deprivation is associated with a higher prevalence of hypertension. Annals Of Epidemiology. 103:9-15. https://doi.org/10.1016/j.annepidem.2025.01.010.
DOI: https://doi.org/10.1016/j.annepidem.2025.01.010

Interpretive Summary: This study looked at over 21,000 teenagers to see if there's a link between the wealth of their school's neighborhood and high blood pressure. They used a measure called the Area Deprivation Index (ADI) to figure out how poor or wealthy a neighborhood is. Schools were categorized into four groups from least deprived to most deprived based on the ADI. The researchers found that teens who went to school in poorer neighborhoods were more likely to have high blood pressure. More Hispanic and African American students attended schools in poorer neighborhoods. Kids in the poorest neighborhoods had the highest rates of high blood pressure, compared to kids in the wealthiest neighborhoods. Even after considering other things like the teen's weight and sex, living in a disadvantaged neighborhood was still linked to higher blood pressure. These findings suggest that growing up in a disadvantaged neighborhood may increase the risk of high blood pressure in teenagers. This could also explain some of the racial and ethnic differences seen in high blood pressure rates. The study highlights the importance of considering social and neighborhood factors when addressing teen health issues.

Technical Abstract: This study examined the association between socioeconomic characteristics of school neighborhoods and the prevalence of hypertension in adolescents. We performed a secondary data analysis of over 21,000 adolescents who participated in a school BP surveillance program between 2000 and 2017. BP status was confirmed by BP measurements on up to 3 occasions to diagnose sustained hypertension according to standard pediatric hypertension guidelines. We assessed school neighborhood socioeconomic status (SES) via the area deprivation index (ADI), a composite measure of area-level socioeconomic deprivation and categorized into quartiles. Q1 represented schools in neighborhoods with the least social deprivation while Q4 represented neighborhood with the most socioeconomic deprivation. We performed a cross-sectional analysis using both univariate and multivariable regression analyses. Of 21,392 children included in our analysis, the prevalence of sustained hypertension was 2.6%. Hispanics and African Americans were overrepresented in the schools in more deprived neighborhoods. The highest sustained hypertension rate was observed among students attending Q3 (5.5%) and Q4 (4.2%) schools compared to Q1 (2.7%) and Q2 (2.0%) schools (p<0.001). Multivariable regression analysis showed that being male, obese, and attending school in a disadvantaged neighborhood were significantly associated with an increased prevalence of hypertension. Our findings suggest that school neighborhood deprivation measured by ADI may be a risk factor for hypertension and may contribute to the racial/ethnic disparities observed in hypertension prevalence in adolescents.