The Importance of Neighborhood Crime, Household Assets, and Sanitation Facilities for Systolic Blood Pressure among South African Adolescents

Paula Griffiths, Loughborough University
Zoe A. Sheppard, Loughborough University
Noel Cameron, Loughborough University
John M. Pettifor, University of the Witwatersrand
Shane Norris, University of the Witwatersrand

This paper models associations between household socio-economic status (SES) in infancy and at 16 years, neighborhood SES at 16 years, and systolic blood pressure (SBP) as well as systolic prehypertension (SPH) in 16 year old South Africans using data from a sub-sample of the 1990 born Birth to Twenty cohort (n= 429, 75% Black, 52% male). Models controlled for sex, ethnicity, maternal age, birthweight, parity, smoking, term birth, height/weight and BMI at 16 years. Results show SPH prevalence was 11%. Neighborhood crime prevention, household sanitation facilities at birth/16 years, and ownership of some consumer durables at birth/16 years were associated with SBP/SPH risk. Where associations between SES and SBP were observed, low SES households/neighborhoods consistently had increased SBP/SPH risk. Targeting crime reduction, helping neighborhoods to feel protected from crime, ensuring good indoor sanitation facilities, and optimal wealth of individuals from infancy to adolescence could improve adolescent SBP in similar environments.