TY - JOUR
T1 - Urban spatial accessibility of primary care and hypertension control and awareness on Chicago’s South side
T2 - A study from the COMPASS cohort
AU - Luo, Jiajun
AU - Kibriya, Muhammad G.
AU - Zakin, Paul
AU - Craver, Andrew
AU - Connellan, Liz
AU - Tasmin, Saira
AU - Polonsky, Tamar
AU - Kim, Karen
AU - Ahsan, Habibul
AU - Aschebrook-Kilfoy, Briseis
N1 - Publisher Copyright:
© 2022 American Heart Association, Inc.
PY - 2022/9/1
Y1 - 2022/9/1
N2 - BACKGROUND: Understanding the relationship between hypertension and spatial accessibility of primary care can inform interventions to improve hypertension control and awareness, especially among disadvantaged populations. This study aims to investigate the association between spatial accessibility of primary care and hypertension control and awareness. METHODS: Participant data from the COMPASS (Chicago Multiethnic Prevention and Surveillance Study) between 2013 and 2019 were analyzed. All participants were geocoded. Locations of primary care providers in Chicago were obtained from MAPSCorps. A score was generated for spatial accessibility of primary care using an enhanced 2-step floating catchment area method. A higher score indicates greater accessibility. Measured hypertension was defined as systolic blood pressure ≥130 mm Hg or diastolic blood pressure ≥80 mm Hg. Logistic regression was used to estimate odds ratio and 95% CI for hypertension status in relation to accessibility score quartiles. RESULTS: Five thousand ninety-six participants (mean age, 53.4±10.8) were included. The study population was predominantly non-Hispanic black (84.0%), over 53% reported an annual household income <$15 000, and 37.3% were obese. Measured hypertension prevalence was 78.7% in this population, among which 37.7% were uncontrolled and 41.0% were unaware. A higher accessibility score was associated with lower measured hypertension prevalence. In fully adjusted models, compared with the first (lowest) quartile of accessibility score, the odds ratio strengthened from 0.82 (95% CI, 0.67–1.01) for the second quartile to 0.75 (95% CI, 0.62–0.91) for the third quartile, and further to 0.73 (95% CI, 0.60–0.89) for the fourth (highest) quartile. The increasing trend had a P<0.01. Similar associations were observed for both uncontrolled and unaware hypertensions. When stratified by neighborhood socioeconomic status, a higher accessibility score was associated with lower rates of unaware hypertension in both disadvantaged and nondisadvantaged neighborhoods. CONCLUSIONS: Better spatial accessibility of primary care is associated with improved hypertension awareness and control.
AB - BACKGROUND: Understanding the relationship between hypertension and spatial accessibility of primary care can inform interventions to improve hypertension control and awareness, especially among disadvantaged populations. This study aims to investigate the association between spatial accessibility of primary care and hypertension control and awareness. METHODS: Participant data from the COMPASS (Chicago Multiethnic Prevention and Surveillance Study) between 2013 and 2019 were analyzed. All participants were geocoded. Locations of primary care providers in Chicago were obtained from MAPSCorps. A score was generated for spatial accessibility of primary care using an enhanced 2-step floating catchment area method. A higher score indicates greater accessibility. Measured hypertension was defined as systolic blood pressure ≥130 mm Hg or diastolic blood pressure ≥80 mm Hg. Logistic regression was used to estimate odds ratio and 95% CI for hypertension status in relation to accessibility score quartiles. RESULTS: Five thousand ninety-six participants (mean age, 53.4±10.8) were included. The study population was predominantly non-Hispanic black (84.0%), over 53% reported an annual household income <$15 000, and 37.3% were obese. Measured hypertension prevalence was 78.7% in this population, among which 37.7% were uncontrolled and 41.0% were unaware. A higher accessibility score was associated with lower measured hypertension prevalence. In fully adjusted models, compared with the first (lowest) quartile of accessibility score, the odds ratio strengthened from 0.82 (95% CI, 0.67–1.01) for the second quartile to 0.75 (95% CI, 0.62–0.91) for the third quartile, and further to 0.73 (95% CI, 0.60–0.89) for the fourth (highest) quartile. The increasing trend had a P<0.01. Similar associations were observed for both uncontrolled and unaware hypertensions. When stratified by neighborhood socioeconomic status, a higher accessibility score was associated with lower rates of unaware hypertension in both disadvantaged and nondisadvantaged neighborhoods. CONCLUSIONS: Better spatial accessibility of primary care is associated with improved hypertension awareness and control.
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U2 - 10.1161/CIRCOUTCOMES.121.008845
DO - 10.1161/CIRCOUTCOMES.121.008845
M3 - Article
C2 - 36065817
AN - SCOPUS:85138458397
SN - 1941-7713
VL - 15
SP - E008845
JO - Circulation: Cardiovascular Quality and Outcomes
JF - Circulation: Cardiovascular Quality and Outcomes
IS - 9
ER -