Historical Differences in School Term Length and Measured Blood Pressure: Contributions to Persistent Racial Disparities among US-Born Adults

Introduction Legally mandated segregation policies dictated significant differences in the educational experiences of black and white Americans through the first half of the 20th century, with markedly lower quality in schools attended by black children. We determined whether school term length, a common marker of school quality, was associated with blood pressure and hypertension among a cohort of older Americans who attended school during the de jure segregation era. Methods National Health and Nutrition Examination Survey I and II data were linked to state level historical information on school term length. We used race and gender-stratified linear regression models adjusted for age, state and year of birth to estimate effects of term length on systolic and diastolic blood pressure (SBP and DBP) and hypertension for US-born adults. We also tested whether correcting years of schooling for term length differences attenuated estimated racial disparities. Results Among black women, 10% longer school term was associated with lower SBP, DBP and hypertension prevalence (2.1 mmHg, 1.0 mmHg, and 5.0 percentage points respectively). Associations for whites and for black men were not statistically significant. Adjustment for education incorporating corrections for differences in school term length slightly attenuated estimated racial disparities. Conclusions Longer school term length predicted better BP outcomes among black women, but not black men or whites

Historical differences in school term length and measured blood pressure: Contributions to persistent racial disparities among US-born adults

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Obstructive sleep apnea risk and psychological health among non-Hispanic blacks in the Metabolic Syndrome Outcome (MetSO) cohort study

INTRODUCTION: This study assessed associations of depression and anxiety with risk of OSA among Non-Hispanic Blacks in the Metabolic Syndrome Outcome (MetSO) study. METHOD: 1,035 patients provided data for the analysis. ARES™ score ≥ 6 defined high OSA risk. Moderate depression was defined by a CES-D score ≥ 16. Moderate anxiety was measured by a BAI score ≥ 16. RESULTS: The mean age was 62 ± 14 years; 70% were female. 93% were diagnosed with hypertension; 61%, diabetes; and 72%, dyslipidemia; 90% were overweight/obese; 33% had a history of heart disease and 10% had a stroke. Logistic regression analysis, adjusting for age and gender, showed that patients with depression had nearly a two-fold increased odds of being at risk for OSA (OR = 1.75, 95% CI = 1.02–2.98, p < .05). Patients with anxiety had a three-fold increased odds of being at risk for OSA (OR = 3.30, 95% CI = 2.11–5.15, p < .01). After adjusting for marital status and income, patients with anxiety had a 6% increase in OSA risk (OR=1.06, 95% CI= 1.04–1.09, p<.05) but depression was no longer significant. CONCLUSION: Our results suggest that Non-Hispanic Blacks with metabolic syndrome who experience anxiety and/or depression should be screened for OSA