Socioeconomic Disparities in Hypertension by Levels of Green Space Availability: A Cross-Sectional Study in Philadelphia, PA
Abstract
:1. Introduction
2. Materials and Methods
2.1. Study Setting
2.2. Outcome (Hypertension)
2.3. Exposure
2.4. Effect Modifier (Green Spaces)
2.5. Covariates
2.6. Statistical Data Analysis
3. Results
4. Discussion
5. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Acknowledgments
Conflicts of Interest
Appendix A
Measure | Categorization |
---|---|
Median household income | Q1 (USD 11,473 to 27,188) Q2 (USD 27,202 to 39,225) Q3 (USD 39,318 to 53,708) Q4 (USD 53,742 to 145,104) |
Tree canopy cover | Low (2–11.8%) Medium (11.8–20.9%) High (21.4–87.9%) |
Distance to nearest park 1 | Low (0–175.6 m) Medium (176.8–332.4 m) High (332.4–2222 m) |
Normalized Difference Vegetation Index (NDVI) | Low (−0.075 to 0.142) Medium (0.142 to 0.237) High (0.238 to 0.530) |
Inclusion | Exclusion |
---|---|
Community Parks, Farms, Gardens, Greenhouses, Nursery, Linear Parks, Parkways, Metropolitan Parks, Mini Parks, Neighborhood Parks, Regional/Watershed Parks, Square/Plaza Parks, and Watershed/Conservation Parks. | Athletic Fields, Barns, Batting Cages, Boathouses, Concessions/Retail/Cafes, Dugouts, Environmental Education Centers, Garages/Maintenance/Storage, Golf Courses and Ranges, Greenhouses/Nursery, Guard Boxes, Historic Houses, Ice Rinks, Lot/Breezeway/Island, Multi-Use Area, Multi-Use Building, Museums, Older Adult Centers, Pavilion/Shelter, Pool, Pumping Station, Recreation Building, Recreation Center, Recreation Site, Restrooms, Shed, Stables, Stage/Stands, Statue/Monument/Sculpture, Weigh Station, Youth and Tot/Play Areas, and Zoo Habitat. |
OR (95% CI) | p-Value | |
---|---|---|
Median Household Income | ||
Q1 | 1.00 (Ref.) | |
Q2 | 0.78 (0.58; 1.06) | 0.118 |
Q3 | 0.73 (0.53; 1.02) | 0.064 |
Q4 | 0.51 (0.36; 0.72) | <0.001 * |
Age (years) | ||
18–34 | 1.00 (Ref.) | |
35–49 | 3.13 (2.04; 4.79) | <0.001 * |
50–64 | 11.26 (7.78; 16.28) | <0.001 * |
65+ | 22.28 (15.18; 32.71) | <0.001 * |
Sex | ||
Male | 1.00 (Ref.) | |
Female | 0.94 (0.76; 1.16) | 0.565 |
Race/Ethnicity | ||
NH White 1 | 1.00 (Ref.) | |
NH Black 1 | 2.13 (1.64; 2.76) | <0.001 * |
Hispanic/Latino | 1.23 (0.8; 1.89) | 0.348 |
Other | 0.75 (0.47; 1.21) | 0.238 |
Our Study | Philadelphia * | |
---|---|---|
Hypertension (yes) | 38.3% | 38.2% |
Age (years) | ||
18–34 | 30.2% | 32.4% |
35–49 | 17.9% | 29.8% |
50–64 | 32.7% | 21.8% |
65+ | 19.1% | 16.0% |
Sex | ||
Male | 45.0% | 46.5% |
Female | 55.0% | 53.5% |
Race/Ethnicity | ||
NH White | 39.9% | 38.2% |
NH Black | 41.4% | 41.5% |
Hispanic/Latino | 12.0% | 12.6% |
Other | 6.8% | 7.7% |
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Hypertension | |||
---|---|---|---|
No (N = 2208) | Yes (N = 1679) | Overall (N = 3887) | |
Tree Canopy Cover | |||
Low | 682 (57%) | 514 (43%) | 1196 |
Medium | 701 (53%) | 617 (47%) | 1318 |
High | 825 (60%) | 548 (40%) | 1373 |
Mean NDVI | |||
Low | 686 (61%) | 439 (39%) | 1125 |
Medium | 668 (50%) | 679 (50%) | 1347 |
High | 854 (60%) | 561 (40%) | 1415 |
Distance to Nearest Park | |||
Low | 700 (57%) | 532 (43%) | 1232 |
Medium | 774 (57%) | 578 (43%) | 1352 |
High | 734 (56%) | 569 (44%) | 1303 |
Age (years) | |||
18–34 | 462 (87%) | 67 (13%) | 529 |
35–49 | 771 (75%) | 263 (25%) | 1034 |
50–64 | 667 (48%) | 716 (52%) | 1383 |
65+ | 308 (33%) | 633 (67%) | 941 |
Sex | |||
Male | 797 (58%) | 586 (42%) | 1383 |
Female | 1411 (56%) | 1093 (44%) | 2504 |
Race/Ethnicity | |||
NH White 1 | 1087 (65%) | 598 (35%) | 1685 |
NH Black 1 | 757 (46%) | 874 (54%) | 1631 |
Hispanic/Latino | 213 (61%) | 135 (39%) | 348 |
Other | 151 (68%) | 72 (32%) | 223 |
Educational Attainment | |||
Less than high school | 142 (37%) | 240 (63%) | 382 |
High school graduate | 670 (51%) | 654 (49%) | 1324 |
Some college or equivalent | 531 (57%) | 406 (43%) | 937 |
College graduate or higher | 865 (70%) | 379 (30%) | 1244 |
Median Household Income | |||
Q1 | 361 (46%) | 416 (54%) | 777 |
Q2 | 599 (54%) | 517 (46%) | 1116 |
Q3 | 627 (59%) | 440 (41%) | 1067 |
Q4 | 609 (67%) | 297 (33%) | 906 |
Missing | 12 (57%) | 9 (43%) | 21 |
OR (95% CI) | p-Value | |
---|---|---|
Educational Attainment | ||
Less than high school | 1.00 (Ref.) | |
High school graduate | 0.63 (0.44; 0.90) | 0.012 * |
Some college or equivalent | 0.57 (0.38; 0.85) | 0.005 * |
College graduate or higher | 0.36 (0.24; 0.53) | <0.001 * |
Age (years) | ||
18–34 | 1.00 (Ref.) | |
35–49 | 3.07 (2.02; 4.66) | <0.001 * |
50–64 | 10.92 (7.57; 15.75) | <0.001 * |
65+ | 20.38 (13.82; 30.04) | <0.001 * |
Sex | ||
Male | 1.00 (Ref.) | |
Female | 0.96 (0.78; 1.19) | 0.73 |
Race/Ethnicity | ||
NH White 1 | 1.00 (Ref.) | |
NH Black 1 | 2.28 (1.79; 2.89) | <0.001 * |
Hispanic/Latino | 1.17 (0.77; 1.76) | 0.465 |
Other | 0.85 (0.53; 1.37) | 0.513 |
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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
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 StyleKoh, 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