October 18, 2025

Abstract TH148: Association of Blood Pressure Control with Distance to Parameters of Social Determinants of Health

AZAnum ZehraUniversity of Maryland, Baltimore SHShuo Jim HuangFoundation for the National Institutes of Health SASinan AktayUniversity of Maryland, Baltimore

Key Points

Achieving a blood pressure goal of ≤140/90 mmHg correlates with greater distance from gun violence incidents, highlighting environmental stressors on health.
Analysis of 8,978 adults with diabetes revealed a significant relationship between blood pressure control and distance to hospitals and gun violence.
The method involved multivariate analyses controlling for urbanicity, age, and type of diabetes, ensuring robust findings on social determinants.
Findings indicate the complexity of associations between health factors and social determinants, calling for more research to explore geographical influences.

Abstract

Introduction: Social determinants of health (SDOH) have been shown to impact access to care and health outcomes. However, the relationship between blood pressure (BP) control and exposure to different SDOH resources and hazards is not well understood. Hypothesis: We hypothesized that achievement of BP goals among people with diabetes will be negatively associated with greater distance to Supplemental Nutrition Assistance Program (SNAP) retailers, hospitals, and pharmacies; and positively associated with greater distance to gun violence incidents. Methods: We assessed attainment of BP ≤140/90 mmHg (primary outcome) and ≤130/80 mmHg (secondary outcome), averaged per year, among adults with diabetes in the University of Maryland Medical System (UMMS) in 2023 and 2024. Encounters with missing BP data, systolic BP 240 mmHg, and diastolic BP 160 mmHg were excluded. The four SDOH paraments tested were distance to a SNAP retailer, hospital, gun violence incident, and pharmacy. These factors were selected to reflect different domains of SDOH that may impact hypertension management. Multivariate analyses controlled for urbanicity, age, and type of diabetes. Results: We included 8,978 adults with diabetes. Achieving BP goal of ≤140/90 mmHg was associated with greater distance from a gun violence incident (OR 93.00, CI: 2.75-3135.84) and greater distance to a hospital (OR 9.15, CI: 2.18-38.41). There was no association between attaining BP ≤140/90 and distance to a SNAP retailer or pharmacy. Greater distance to hospital (OR 2.32, CI: 1.07-5.01) was also associated with achievement of BP ≤130/80 mmHg. Conclusion: BP control was associated with some, but not all, SDOH indicators tested among adults with diabetes within a large, state-wide health system. While BP target attainment was more likely with further distance from gun violence incidents (a major stressor), there was no association with proximity to SNAP (food) retailers or pharmacies, and the association with distance to the hospital was inverse to our hypothesis. Further analyses are needed to quantify and explore the role of geographical SDOH parameters on BP control.

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