Purpose: To examine the extent to which neighborhood disadvantage accounts for variation in blood pressure. Methods: Demographic, biometric, and self-reported data from 19 261 health screenings were used. Addresses of participants were geocoded and located within census block groups (n= 14 510, 75.3%). Three hierarchical linear models were formulated to identify individual and census block group risk factors for hypertension. Neighborhood-level deprivation was determined using the Townsend Deprivation Index. Results: Of the 14 510 participants, 24% had a systolic blood pressure (SBP) of = 140 mmHg, and 15% had a diastolic blood pressure (DBP) of = 90 mmHg, indicating hypertension. At the neighborhood level, significant variation in average SBP and DBP across census block groups (P < .001) was found. Model 2 suggested that deprivation accounts for some of the variability in average SBP and DBP between block groups (P < .001). After controlling for individual-level risk factors in model 3, deprivation remained a significant predictor of average SBP (P= .009). Discussion: The findings highlight the role of individual and neighborhood characteristics on blood pressure, specifically SBP. Modifying neighborhood contexts may help reduce environmental risks of hypertension. Translation to Health Education Practice: Educating officials about health risks for residents associated with neighborhood resources is essential in changing policies and reallocating resources.
