Onugha Elizabeth A, Banerjee Ankona, Nobleza Kenneth J, Nguyen Duc T, Rosales Omar, Oluyomi Abiodun, Dave Jayna M, Samuels Joshua
Department of Pediatrics, Baylor College of Medicine, Houston, TX, USA.
Department of Pediatrics, Baylor College of Medicine, Houston, TX, USA.
Ann Epidemiol. 2025 Mar;103:9-15. doi: 10.1016/j.annepidem.2025.01.010. Epub 2025 Jan 31.
To examine 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.
研究学校周边社区的社会经济特征与青少年高血压患病率之间的关联。
我们对2000年至2017年间参与学校血压监测项目的21000多名青少年进行了二次数据分析。根据标准儿科高血压指南，通过最多3次血压测量来确认血压状况，以诊断持续性高血压。我们通过地区贫困指数（ADI）评估学校周边社区的社会经济地位（SES），ADI是地区层面社会经济剥夺的综合指标，并分为四分位数。Q1代表社会剥夺最少社区的学校，而Q4代表社会经济剥夺最多社区的学校。我们使用单变量和多变量回归分析进行横断面分析。
在我们分析的21392名儿童中，持续性高血压的患病率为2.6%。在贫困程度较高社区的学校中，西班牙裔和非裔美国人占比过高。与Q1（2.7%）和Q2（2.0%）学校的学生相比，在Q3（5.5%）和Q4（4.2%）学校就读的学生中观察到最高的持续性高血压发生率（p<0.001）。多变量回归分析表明，男性、肥胖以及在弱势社区上学与高血压患病率增加显著相关。
我们的研究结果表明，通过ADI衡量的学校周边社区剥夺可能是高血压的一个风险因素，并且可能导致青少年高血压患病率中观察到的种族/民族差异。
