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Article

Socioeconomic Disparities in Hypertension by Levels of Green Space Availability: A Cross-Sectional Study in Philadelphia, PA

1
Department of Epidemiology and Biostatistics, Drexel University Dornsife School of Public Health, 3215 Market St., Philadelphia, PA 19104, USA
2
Urban Health Collaborative, Drexel University Dornsife School of Public Health, 3600 Market St., Philadelphia, PA 19104, USA
3
Northern Research Station, United States Department of Agriculture–Forest Service, 100 N. St., Ste 205, Philadelphia, PA 19103, USA
*
Author to whom correspondence should be addressed.
Academic Editor: Paloma Cariñanos
Int. J. Environ. Res. Public Health 2022, 19(4), 2037; https://doi.org/10.3390/ijerph19042037
Received: 13 December 2021 / Revised: 8 February 2022 / Accepted: 8 February 2022 / Published: 11 February 2022
(This article belongs to the Special Issue 2nd Edition of Urban Green Spaces)
Green spaces have been proposed as equigenic factors, potentially mitigating health disparities. We used data from the 3887 participants residing in Philadelphia who participated in the Public Health Management Corporation’s Southeastern Pennsylvania Household Health Survey in 2014–2015 to assess whether socioeconomic disparities in hypertension are modified by availability of neighborhood-level green spaces. Socioeconomic status (SES) was measured using individual-level education and neighborhood-level median household income. Green space availability was measured using surrounding percent tree canopy cover, mean normalized difference vegetation index (NDVI), and proximity to nearest park. Using logistic regression models adjusted for age, sex, and race/ethnicity, we found that adults with higher educational attainment had significantly lower levels of hypertension (OR = 0.63, 0.57, and 0.36 for high school, some college, and college graduates, respectively, as compared to those with less than high school education), and this pattern was similar for median household income (higher prevalence in lower income areas). We found no significant interaction between education and percent tree canopy cover (p = 0.83), meaning that educational disparities in hypertension were similar across all levels of green space availability. These results held when using mean NDVI or distance to nearest park as availability measures, or when considering neighborhood-level median household income as the socioeconomic measure, although the specific patterns and significance of interactions varied by exposure and modifier. While socioeconomic disparities in hypertension are strong for adults residing in Philadelphia, green spaces did not seem to modify them. View Full-Text
Keywords: green spaces; hypertension; socioeconomic status; health equity; Philadelphia green spaces; hypertension; socioeconomic status; health equity; Philadelphia
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MDPI and ACS Style

Koh, C.; Kondo, M.C.; Rollins, H.; Bilal, U. Socioeconomic Disparities in Hypertension by Levels of Green Space Availability: A Cross-Sectional Study in Philadelphia, PA. Int. J. Environ. Res. Public Health 2022, 19, 2037. https://doi.org/10.3390/ijerph19042037

AMA Style

Koh C, Kondo MC, Rollins H, Bilal U. Socioeconomic Disparities in Hypertension by Levels of Green Space Availability: A Cross-Sectional Study in Philadelphia, PA. International Journal of Environmental Research and Public Health. 2022; 19(4):2037. https://doi.org/10.3390/ijerph19042037

Chicago/Turabian Style

Koh, Celina, Michelle C. Kondo, Heather Rollins, and Usama Bilal. 2022. "Socioeconomic Disparities in Hypertension by Levels of Green Space Availability: A Cross-Sectional Study in Philadelphia, PA" International Journal of Environmental Research and Public Health 19, no. 4: 2037. https://doi.org/10.3390/ijerph19042037

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