Longitudinal Associations of Neighborhood Crime and Perceived Safety With Blood Pressure: The Multi-Ethnic Study of Atherosclerosis (MESA)

BACKGROUND High neighborhood crime and low perceptions of safety may influence blood pressure (BP) through chronic stress. Few studies have examined these associations using longitudinal data. METHODS We used longitudinal data from 528 participants of the Multi-Ethnic Study of Atherosclerosis (aged 45-84, nonhypertensive at baseline) who lived in Chicago, Illinois. We examined associations of changes in individual-level perceived safety, aggregated neighborhood-level perceived safety, and past-year rates of police-recorded crime in a 1, 1/2, or 1/4 mile buffer per 1,000 population with changes in systolic and diastolic BPs using fixed-effects linear regression. BP was measured five times between 2000 and 2012 and was adjusted for antihypertensive medication use (+10 mm Hg added to systolic and +5 mm Hg added to diastolic BP for participants on medication). Models were adjusted for time-varying sociodemographic and health-related characteristics and neighborhood socioeconomic status. We assessed differences by sex. RESULTS A standard deviation increase in individual-level perceived safety was associated with a 1.54 mm Hg reduction in systolic BP overall (95% confidence interval [CI]: 0.25, 2.83), and with a 1.24 mm Hg reduction in diastolic BP among women only (95% CI: 0.37, 2.12) in adjusted models. Increased neighborhood-level safety was not associated with BP change. An increase in police-recorded crime was associated with a reduction in systolic and diastolic BPs among women only, but results were sensitive to neighborhood buffer size. CONCLUSIONS Results suggest individual perception of neighborhood safety may be particularly salient for systolic BP reduction relative to more objective neighborhood exposures.