Relationship between spatial accessibility to primary care and hypertension status

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Created On: 18/11/2022

The purpose of this study was to assess the relationship between primary care's spatial accessibility and hypertension management and awareness.

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Key take away

Better primary care spatial accessibility was related to decreased occurrence of both unaware and uncontrolled hypertension.

Background

The purpose of this study was to assess the relationship between primary care's spatial accessibility and hypertension management and awareness.

Method

The COMPASS (Chicago Multiethnic Prevention and Surveillance Study) participant data were examined. All the subjects were geocoded. MAPSCorps provided locations of primary medical care doctors. Utilizing an improved 2-step floating catchment area technique, the score for spatial accessibility of basic healthcare was created.

A higher score suggested better ease of access. Hypertension was described as having ≥80 mm Hg of diastolic blood pressure or ≥130 mm Hg of systolic blood pressure. The odds ratio and 95% CI for hypertension status related to accessibility score quartiles were estimated using logistic regression.

Result

There were 5096 subjects (mean age, 53.4 ± 10.8) in total. The research population was primarily non-Hispanic black (84.0%), with more than 53% reporting an annual family income of less than $15000 and 37.3% being obese. In this cohort, measured hypertension occurrence was 78.7%, with 41.0% unaware and 37.7% uncontrolled. A greater accessibility score was connected with a lower measured occurrence of hypertension.

In fully adjusted models, the odds ratio increased from 0.82 for the 2nd quartile to 0.75 for the 3rd quartile and further to 0.73 for the 4th (highest) quartile when compared to the 1st (lowest) quartile of accessibility score. Both unaware and uncontrolled hypertension were shown to have similar relationships. A greater accessibility score was related to reduced rates of unaware hypertension in both nondisadvantaged and disadvantaged communities when graded using neighbourhood socioeconomic status.

Conclusion

In a predominantly lower socioeconomic status cohort, the spatial accessibility of primary care was related to awareness and control of hypertension, even after adjusting for or stratifying by neighbourhood socioeconomic position. Interventions that improve access to primary care doctors might help residents in underserved areas.