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Ethnic differences in the effect of environmental stressors on blood pressure and hypertension in the Netherlands.

Agyemang C, van Hooijdonk C, Wendel-Vos W, Ujcic-Voortman JK, Lindeman E, Stronks K, Droomers M - BMC Public Health (2007)

Bottom Line: Similar associations were observed among the Dutch group but none of the differences were statistically significant.These findings might imply that the higher BP levels found in some ethnic minority groups might be partly due to their greater susceptibility to the adverse neighbourhood environment in which many ethnic minority people live.Primary prevention measures targeting these neighbourhood stressors may have an impact in reducing high BP related morbidity and mortality among ethnic minority groups.

View Article: PubMed Central - HTML - PubMed

Affiliation: Centre for Prevention and Health Services Research, National Institute for Public Health and the Environment, Bilthoven, The Netherlands. c.o.agyemang@amc.uva.nl

ABSTRACT

Background: Evidence strongly suggests that the neighbourhood in which people live influences their health. Despite this, investigations of ethnic differences in cardiovascular risk factors have focused mainly on individual-level characteristics. The main purpose of this study was to investigate associations between neighbourhood-level environmental stressors (crime, housing density, nuisance from alcohol and drug misuse, quality of green space and social participation), and blood pressure (BP) and hypertension among different ethnic groups.

Methods: Individual data from the Amsterdam Health Survey 2004 were linked to data on neighbourhood stressors creating a multilevel design for data analysis. The study sample consisted of 517 Dutch, 404 Turkish and 365 Moroccans living in 15 neighbourhoods in Amsterdam, the Netherlands.

Results: Amongst Moroccans, high density housing and nuisance from drug misuse were associated with a higher systolic BP, while high quality of green space and social participation were associated with a lower systolic BP. High level of nuisance from drug misuse was associated with a higher diastolic BP. High quality of green space was associated with lower odds of hypertension. Amongst Turkish, high level of crime and nuisance from motor traffic were associated with a higher diastolic BP. Similar associations were observed among the Dutch group but none of the differences were statistically significant.

Conclusion: The study findings show that neighbourhood-level stressors are associated with BP in ethnic minority groups but were less evident in the Dutch group. These findings might imply that the higher BP levels found in some ethnic minority groups might be partly due to their greater susceptibility to the adverse neighbourhood environment in which many ethnic minority people live. Primary prevention measures targeting these neighbourhood stressors may have an impact in reducing high BP related morbidity and mortality among ethnic minority groups.

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Mentions: The individual level data came from the Amsterdam Health Survey 2004. This cross-sectional study was carried out by Amsterdam Municipal Health Service (GGD Amsterdam) in collaboration with the National Institute for Public Health and Environment (RIVM) to monitor the health of the Amsterdam general population aged ≥18 years. The study sample was drawn from the Amsterdam municipal registers in five city districts in Amsterdam (Figure 1). The population of these districts combined is representative for the total population of Amsterdam. The sample was stratified by ethnicity and five age groups (18–34 years, 35–44 years, 45–54 years, 55–64 years and 65 years or older). Within each stratum a random sample was drawn. The Turkish and Moroccan ethnic groups were oversampled to ensure sufficient numbers of people from these groups. This method was necessary to boost Turkish and Moroccan ethnic groups in the sample because of their relatively low representation in the total population and their lower participation rate in national and local surveys in the Netherlands. In 2004, the people in the sample were invited for an interview and medical examination in a community health centre. All interviews were conducted in the language of choice of the respondent (i.e., Dutch, Turkish, Moroccan-Arabic or Berber). The final response rate was 44% (Dutch 46%, Turks 50% and Moroccans 39%). Data were weighted to correct for oversampling by ethnic groups. All participants signed a consent form. The Medical Ethical Committee of the Amsterdam Medical Centre approved the study protocols.


Ethnic differences in the effect of environmental stressors on blood pressure and hypertension in the Netherlands.

Agyemang C, van Hooijdonk C, Wendel-Vos W, Ujcic-Voortman JK, Lindeman E, Stronks K, Droomers M - BMC Public Health (2007)

© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC1919368&req=5

Mentions: The individual level data came from the Amsterdam Health Survey 2004. This cross-sectional study was carried out by Amsterdam Municipal Health Service (GGD Amsterdam) in collaboration with the National Institute for Public Health and Environment (RIVM) to monitor the health of the Amsterdam general population aged ≥18 years. The study sample was drawn from the Amsterdam municipal registers in five city districts in Amsterdam (Figure 1). The population of these districts combined is representative for the total population of Amsterdam. The sample was stratified by ethnicity and five age groups (18–34 years, 35–44 years, 45–54 years, 55–64 years and 65 years or older). Within each stratum a random sample was drawn. The Turkish and Moroccan ethnic groups were oversampled to ensure sufficient numbers of people from these groups. This method was necessary to boost Turkish and Moroccan ethnic groups in the sample because of their relatively low representation in the total population and their lower participation rate in national and local surveys in the Netherlands. In 2004, the people in the sample were invited for an interview and medical examination in a community health centre. All interviews were conducted in the language of choice of the respondent (i.e., Dutch, Turkish, Moroccan-Arabic or Berber). The final response rate was 44% (Dutch 46%, Turks 50% and Moroccans 39%). Data were weighted to correct for oversampling by ethnic groups. All participants signed a consent form. The Medical Ethical Committee of the Amsterdam Medical Centre approved the study protocols.

Bottom Line: Similar associations were observed among the Dutch group but none of the differences were statistically significant.These findings might imply that the higher BP levels found in some ethnic minority groups might be partly due to their greater susceptibility to the adverse neighbourhood environment in which many ethnic minority people live.Primary prevention measures targeting these neighbourhood stressors may have an impact in reducing high BP related morbidity and mortality among ethnic minority groups.

View Article: PubMed Central - HTML - PubMed

Affiliation: Centre for Prevention and Health Services Research, National Institute for Public Health and the Environment, Bilthoven, The Netherlands. c.o.agyemang@amc.uva.nl

ABSTRACT

Background: Evidence strongly suggests that the neighbourhood in which people live influences their health. Despite this, investigations of ethnic differences in cardiovascular risk factors have focused mainly on individual-level characteristics. The main purpose of this study was to investigate associations between neighbourhood-level environmental stressors (crime, housing density, nuisance from alcohol and drug misuse, quality of green space and social participation), and blood pressure (BP) and hypertension among different ethnic groups.

Methods: Individual data from the Amsterdam Health Survey 2004 were linked to data on neighbourhood stressors creating a multilevel design for data analysis. The study sample consisted of 517 Dutch, 404 Turkish and 365 Moroccans living in 15 neighbourhoods in Amsterdam, the Netherlands.

Results: Amongst Moroccans, high density housing and nuisance from drug misuse were associated with a higher systolic BP, while high quality of green space and social participation were associated with a lower systolic BP. High level of nuisance from drug misuse was associated with a higher diastolic BP. High quality of green space was associated with lower odds of hypertension. Amongst Turkish, high level of crime and nuisance from motor traffic were associated with a higher diastolic BP. Similar associations were observed among the Dutch group but none of the differences were statistically significant.

Conclusion: The study findings show that neighbourhood-level stressors are associated with BP in ethnic minority groups but were less evident in the Dutch group. These findings might imply that the higher BP levels found in some ethnic minority groups might be partly due to their greater susceptibility to the adverse neighbourhood environment in which many ethnic minority people live. Primary prevention measures targeting these neighbourhood stressors may have an impact in reducing high BP related morbidity and mortality among ethnic minority groups.

Show MeSH
Related in: MedlinePlus