Neighborhood Context and Hypertension Outcomes Among Latinos in Chicago

Although a health advantage in hypertension has been documented among Latinos, this advantage appears to be eroding. Of particular
concern is the observation that Latinos are less likely to be screened and treated for hypertension and to having it controlled.
Scholars have suggested that, above and beyond individual-level factors, neighborhood characteristics may be important predictors
of health and health care. We analyzed 2001–2003 data from the Chicago Community Adult Health Study to examine (a) the relationship
between the Latino and immigrant composition of neighborhoods in Chicago and several outcomes among Latinos: having hypertension,
utilizing hypertension-related health care, and being treated for hypertension; and (b) whether there was a differential effect
of neighborhood Latino/immigrant concentration by language of interview and nativity status. We controlled for additional
neighborhood characteristics relevant to hypertension and to the availability and accessibility of health care resources.
Neighborhoods with higher concentrations of immigrants and Latinos were associated with Latinos having lower odds of hypertension
(OR = 0.60, p = 0.03). However, among those with hypertension, our results point to deleterious effects on hypertension care (OR = 0.55,
p = 0.06) and treatment (OR = 0.54, p = 0.04) associated with living in neighborhoods with higher concentrations of immigrants and Latinos. We detected no significant
interaction effects between immigrant/Latino neighborhood composition and language of interview or being an immigrant in this
sample. These results suggest that improving access to care for Latinos with hypertension requires enhanced placement of community
clinics and other safety-net health centers in neighborhoods with higher proportions of immigrants and Latinos.