Living in racially segregated neighborhoods may increase the risk of developing hypertension, especially for Black Americans, according to a new study from the REGARDS cohort. Researchers found that higher scores on the isolation index—a measure of how often Black residents interact only with other Black residents—were associated with increased hypertension risk. The risk ratio rose by 6% for every standard deviation increase in isolation.
Neighborhood socioeconomic status (nSES) played a key role. It explained 19% of the association between segregation and hypertension, suggesting that higher nSES may buffer some of the negative health effects of segregation. “Higher neighborhood socioeconomic status may mitigate the negative effects of that aspect of residential segregation on hypertension development,” the authors wrote.
While the dissimilarity index, which measures racial distribution across census tracts, showed no significant link to hypertension overall, it was marginally associated with lower risk in Black participants. This may reflect the “ethnic density effect,” where living among people of similar backgrounds fosters social cohesion and reduces exposure to discrimination.
Importantly, the study found no significant association between residential segregation and hypertension risk in White participants. The authors suggest that structural racism may amplify the health impact of segregation for Black Americans, while White residents may be shielded by systemic advantages.
These findings underscore the need to address structural racism and improve neighborhood conditions to reduce health disparities.
See: “Residential Racial Segregation, Socioeconomic Status, and Hypertension Risk in Black and White Americans” (September 30, 2025)
