Primary Submission Category: Environmental factors
Association Between Self-Reported Lack of Access to a Neighborhood Park and High Blood Pressure
Authors: Stephanie Kjelstrom Richard Hass Russell McIntire
Presenting Author: Stephanie Kjelstrom*
Prior studies found a lower risk of high blood pressure (HBP) with proximity to green spaces. Several studies have connected neighborhood environment and area deprivation to physical activity and park usage. We considered access to and feeling comfortable visiting neighborhood parks and their association with self-reported HBP. As well as effect modification by race, education, and poverty status.
A representative sample of adults from the 2018 Southeastern Pennsylvania Household Health Survey was asked if they had ever been told they had HBP by a healthcare provider, and if there is a neighborhood park or outdoor space they are comfortable visiting during the day. Response options for the park question were “Yes, there is a park in your neighborhood that you are comfortable visiting”, “No, there is no park in your neighborhood” and “No, there is a park in your neighborhood, but you are not comfortable visiting it”. To assess the association between HBP and park access and perceptions, we built multivariable multi-level logistic models to account for variation by zip code. Interactions were added to the model to analyze effect modification.
In our unadjusted model, not having a neighborhood park and having a park but not feeling comfortable visiting were associated with 70% and 90% higher odds of HBP, compared to having a park and feeling comfortable visiting. After adjustment, the odds ratios for both park answers remained significant (aOR 1.4 (1.1, 1.7), aOR 1.4 (1.03, 2.0)). Compared to Whites with a park, Blacks’ odds of HBP increased with less access (95% (with park), 169% (no park), 250% (park not comfortable). No effect was observed for education or poverty.
We can infer from our results that even after accounting for other risk factors for HBP, not having a park in a neighborhood or having a park but not feeling comfortable visiting may influence individual BP. Neighborhood factors that deter park access may contribute to racial disparities in HBP.