Gender differences in the association of individual and contextual socioeconomic status with hypertension in 230 Latin American cities from the SALURBAL study: a multilevel analysis

BMC Public Health

Research

Amanda Cristina de Souza Andrade¹  Ana V. Diez-Roux²  Mariana Lazo²  S. Claire Slesinski²  Alex Quistberg²  Amélia Augusta de Lima Friche³  Waleska Teixeira Caiaffa³  Débora Moraes Coelho³  Uriel Moreira Silva³ 

[1] Belo Horizonte Observatory for Urban Health, Avenida Alfredo Balena 190, 30130-100, Belo Horizonte, Brazil;Institute of Public Health, Federal University of Mato Grosso, Avenida Fernando Corrêa 2367, 78060-900, Cuiabá, Brazil;Dornsife School of Public Health, Drexel University, 3215 Market Street, 19104, Philadelphia, PA, USA;Faculty of Medicine, Federal University of Minas Gerais, Avenida Alfredo Balena 190, 30130-100, Belo Horizonte, Brazil;Belo Horizonte Observatory for Urban Health, Avenida Alfredo Balena 190, 30130-100, Belo Horizonte, Brazil;

关键词: Urban health;    Hypertension;    Education;    Socioeconomic status;    Latin America;    Multilevel analysis;   

DOI  :  10.1186/s12889-023-16480-3

 received in 2023-01-16, accepted in 2023-08-08,  发布年份 2023

来源: Springer

【 摘 要 】

BackgroundDespite global interest in gender disparities and social determinants of hypertension, research in urban areas and regions with a high prevalence of hypertension, such as Latin America, is very limited.The objective of this study was to examine associations of individual- and area-level socioeconomic status with hypertension in adults living in 230 cities in eight Latin America countries.MethodsIn this cross-sectional study, we used harmonized data from 109,184 adults (aged 18–97 years) from the SALURBAL (Salud Urbana en America Latina/Urban Health in Latin America) project. Hypertension was assessed by self-report. Individual-, sub-city- and city-level education were used as proxies of socioeconomic status. All models were stratified by gender.ResultsHigher individual-level education was associated with lower odds of hypertension among women (university education or higher versus lower than primary: odds ratio [OR] = 0.67, 95% confidence interval [CI] = 0.61–0.74) but higher odds among men (OR = 1.65; 95%CI 1.47–1.86), although in men an inverse association emerged when measured blood pressure was used (OR = 0.86; 95%CI 0.76–0.97). For both genders, living in sub-city areas with higher educational achievement was associated with higher odds of hypertension (OR per standard deviation [SD] = 1.07, 95%CI = 1.02–1.12; OR = 1.11 per SD, 95%CI = 1.05–1.18, for women and men, respectively). The association of city-level education with hypertension varied across countries. In Peru, there was an inverse association (higher city level education was associated with lower odds of hypertension) in women and men, but in other countries no association was observed. In addition, the inverse association of individual-level education with hypertension became stronger (in women) or emerged (in men) as city or sub-city education increased.ConclusionThe social patterning of hypertension differs by gender and by the level of analysis highlighting the importance of context- and gender-sensitive approaches and policies to reduce the prevalence of hypertension in Latin America.

【 授权许可】

CC BY   
© BioMed Central Ltd., part of Springer Nature 2023

【 图 表 】

Fig. 1

41522_2023_426_Article_IEq8.gif