Introduction
Hypertension is associated with adverse cardiovascular outcomes and is geographically
concentrated in urban underserved neighborhoods. This study examines the temporal–spatial
association between individual exposure to violent crime and blood pressure.
Methods
A retrospective observational cohort study analyzed 39,211 patients with 227,595 blood
pressure measurements from 2014 to 2016 at 3 outpatient clinics at an academic medical
center in Chicago. Patients were included in the study if they had documentation of
blood pressure in the medical record and resided in census tracts with >1,000 observations.
Geocoded violent crime events were obtained from the Chicago Police Department. Individual-level
exposure was defined on the basis of spatial and temporal buffers around each patient's
home. Spatial buffers included 100-, 250-, 500-, and 1,000-meter disc radii, and temporal
buffers included 7, 30, and 60 days preceding each outpatient appointment. Systolic
blood pressure measurements (mmHg) were abstracted from the electronic health record.
Analysis was performed in 2019–2020.
Results
For each violent crime event within 100 meters from home, systolic blood pressure
increased by 0.14 mmHg within 7 days of exposure compared with 0.08 mmHg at 30 days
of exposure. In analyses stratified by neighborhood cluster, systolic blood pressure
increased by 0.37 mmHg among patients in the suburban affluent cluster relative to
that among those in an extreme poverty cluster for the same spatial and temporal buffer.
Conclusions
Exposure to a violent crime event was associated with increased blood pressure, with
gradient effects by both distance and time from exposure.
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Article Info
Publication History
Published online: September 15, 2021
Identification
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© 2021 American Journal of Preventive Medicine. Published by Elsevier Inc. All rights reserved.
