Journal of Behavioral Medicine

, Volume 37, Issue 1, pp 113–126 | Cite as

How neighborhood disorder increases blood pressure in youth: agonistic striving and subordination

  • Craig K. Ewart
  • Gavin J. Elder
  • Joshua M. Smyth
Original Paper


Growing evidence links perceptions of neighborhood disorder to adverse health outcomes but little is known about psychological processes that may mediate this association. We tested the hypothesis that two psychological mechanisms—agonistic striving and subordination—mediate the link between perceived neighborhood disorder and hypertension risk in youth. Perceived neighborhood disorder, agonistic striving, subordination experiences, negative affect, obesity, and ambulatory blood pressure during daily activities (48 h) were assessed in a multiethnic sample of 167 low- to middle-income urban adolescents. Path analyses revealed that agonistic striving, subordination, and obesity each independently mediated the association between neighborhood disorder and blood pressure; these variables accounted for 73 % of the shared variance, 42 % of which was explained by agonistic striving. The direct relationship between perceived neighborhood disorder and blood pressure was no longer significant in the presence of these mediators. Negative affect was associated with neighborhood disorder and subordination, but not blood pressure. Agonistic striving proved to be a significant and substantial mediator of the association between perceived neighborhood disorder, blood pressure, and future hypertension risk. New research should seek to clarify the processes by which stressful neighborhoods induce persistent agonistic motives and perceptions of subordination in adolescents.


Adolescent health Perceived neighborhood disorder Agonistic striving Social power Subordination Implicit motives Hypertension risk 



This research was supported by grant R01-HL75555 from the National Heart, Lung, and Blood Institute, awarded to Craig K. Ewart. We thank Mindi Ditmar and Michelle Hallahan who served as project coordinators, and Nina Stoeckel, Rachel Herman, and Erin Sullivan for assistance in data collection and coding. We also thank Jill Stewart for serving as liaison with Henninger High School. We thank Randall S. Jorgensen and Aesoon Park who commented on earlier drafts of the manuscript.


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Copyright information

© Springer Science+Business Media New York 2012

Authors and Affiliations

  • Craig K. Ewart
    • 1
  • Gavin J. Elder
    • 1
  • Joshua M. Smyth
    • 1
    • 2
  1. 1.Department of Psychology, Center for Health and BehaviorSyracuse UniversitySyracuseUSA
  2. 2.Department of Biobehavioral HealthPennsylvania State UniversityUniversity ParkUSA

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