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Social context as an explanation for race disparities in hypertension: Findings from the Exploring Health Disparities in Integrated Communities (EHDIC) Study

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  • Thorpe Jr., Roland J.
  • Brandon, Dwayne T.
  • LaVeist, Thomas A.

Abstract

Disparities in hypertension between African Americans and non-Hispanic whites have been well-documented, yet an explanation for this persistent disparity remains elusive. Since African Americans and non-Hispanic white Americans tend to live in very different social environments, it is not known whether race disparities in hypertension would persist if non-Hispanic whites and African Americans were exposed to similar social environments. We compared data from the Exploring Health Disparities in Integrated Communities-SWB (EHDIC-SWB) Study with the National Health and Nutrition Examination Survey (NHANES) 1999-2004 to determine if race disparities in hypertension in the USA were attenuated in EHDIC-SWB, which is based in a racially integrated community without race differences in income. Hypertension was defined as systolic blood pressure (BP)Â >=Â 140Â mmHg (millimeters of mercury) and/or diastolic BPÂ >=Â 90Â mmHg or respondent's report of taking antihypertensive medications. Of the 1408 study participants, 835 (59.3%) were African American, 628 (44.6%) were men, and the mean age was 40.6 years. After adjustment for potential confounders, various analytic models from EHDIC-SWB and NHANES 1999-2004 data, we found the race odds ratio was between 29.0% and 34% smaller in the EHDIC-SWB sample. We conclude that social and environmental exposures explained a substantial proportion of the race difference in hypertension.

Suggested Citation

  • Thorpe Jr., Roland J. & Brandon, Dwayne T. & LaVeist, Thomas A., 2008. "Social context as an explanation for race disparities in hypertension: Findings from the Exploring Health Disparities in Integrated Communities (EHDIC) Study," Social Science & Medicine, Elsevier, vol. 67(10), pages 1604-1611, November.
  • Handle: RePEc:eee:socmed:v:67:y:2008:i:10:p:1604-1611
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    1. Coulon, Sandra M. & Wilson, Dawn K. & Egan, Brent M., 2013. "Associations among environmental supports, physical activity, and blood pressure in African-American adults in the PATH trial," Social Science & Medicine, Elsevier, vol. 87(C), pages 108-115.
    2. Zeng, Di & You, Wen & Mills, Bradford & Alwang, Jeffrey & Royster, Michael & Anson-Dwamena, Rexford, 2015. "A closer look at the rural-urban health disparities: Insights from four major diseases in the Commonwealth of Virginia," Social Science & Medicine, Elsevier, vol. 140(C), pages 62-68.
    3. Heather M. Rackin, 2017. "Comparing Veteran and Non-veteran Racial Disparities in Mid-life Health and Well-being," Population Research and Policy Review, Springer;Southern Demographic Association (SDA), vol. 36(3), pages 331-356, June.
    4. Lukachko, Alicia & Hatzenbuehler, Mark L. & Keyes, Katherine M., 2014. "Structural racism and myocardial infarction in the United States," Social Science & Medicine, Elsevier, vol. 103(C), pages 42-50.

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