African Americans, African Immigrants, and Afro-Caribbeans Differ in Social Determinants of Hypertension and Diabetes

Evidence from the National Health Interview Survey

Yvonne Commodore-Mensah, Nadine Matthie, Jessica Wells, Sandra B. Dunbar, Cheryl Renee Dennison-Himmelfarb, Lisa A Cooper, Rasheeta D. Chandler

Research output: Contribution to journalArticle

Abstract

In the United States (U.S.), Blacks have higher morbidity and mortality from cardiovascular disease (CVD) than other racial groups. The Black racial group includes African Americans (AAs), African immigrants (AIs), and Afro-Caribbeans (ACs); however, little research examines how social determinants differentially influence CVD risk factors in each ethnic subgroup. We analyzed the 2010–2014 National Health Interview Survey, a cross-sectional, nationally representative survey of non-institutionalized civilians. We included 40,838 Blacks: 36,881 AAs, 1660 AIs, and 2297 ACs. Age- and sex-adjusted hypertension prevalence was 37, 22, and 21% in AAs, ACs, and AIs, respectively. Age- and sex-adjusted diabetes prevalence was 12, 10, and 7% in AAs, ACs, and AIs, respectively. In the multivariable logistic regression analyses, social determinants of hypertension and diabetes differed by ethnicity. Higher income was associated with lower odds of hypertension in AAs (aOR 0.86, 95% CI 0.77–0.96) and ACs (aOR 0.55, 95% CI 0.37–0.83). In AAs, those with some college education (aOR 0.79, 95% CI 0.68–0.92) and college graduates (aOR 0.62, 95% CI 0.53–0.73) had lower odds of hypertension than those with < high school education. In AIs, having health insurance was associated with higher odds of hypertension (aOR 1.59, 95% CI 1.04–2.42) and diabetes (aOR 3.22, 95% CI 1.29–8.04) diagnoses. We observed that the social determinants associated with hypertension and diabetes differed by ethnicity. Socioeconomic factors of health insurance and income were associated with a disparate prevalence of hypertension by ethnic group. Future research among Blacks should stratify by ethnicity to adequately address the contributors to health disparities.

Original languageEnglish (US)
Pages (from-to)1-8
Number of pages8
JournalJournal of racial and ethnic health disparities
DOIs
StateAccepted/In press - Dec 12 2017

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hypertension
Health Surveys
African Americans
chronic illness
immigrant
Interviews
determinants
Hypertension
interview
health
evidence
ethnicity
Health Insurance
health insurance
Cardiovascular Diseases
Disease
Education
income
socioeconomic factors
school education

Keywords

  • Diabetes
  • Hypertension
  • Immigrants
  • Obesity
  • Race ethnicity

ASJC Scopus subject areas

  • Health(social science)
  • Anthropology
  • Sociology and Political Science
  • Health Policy
  • Public Health, Environmental and Occupational Health

Cite this

@article{c17265615f384d4daaedea75ff90a0b8,
title = "African Americans, African Immigrants, and Afro-Caribbeans Differ in Social Determinants of Hypertension and Diabetes: Evidence from the National Health Interview Survey",
abstract = "In the United States (U.S.), Blacks have higher morbidity and mortality from cardiovascular disease (CVD) than other racial groups. The Black racial group includes African Americans (AAs), African immigrants (AIs), and Afro-Caribbeans (ACs); however, little research examines how social determinants differentially influence CVD risk factors in each ethnic subgroup. We analyzed the 2010–2014 National Health Interview Survey, a cross-sectional, nationally representative survey of non-institutionalized civilians. We included 40,838 Blacks: 36,881 AAs, 1660 AIs, and 2297 ACs. Age- and sex-adjusted hypertension prevalence was 37, 22, and 21{\%} in AAs, ACs, and AIs, respectively. Age- and sex-adjusted diabetes prevalence was 12, 10, and 7{\%} in AAs, ACs, and AIs, respectively. In the multivariable logistic regression analyses, social determinants of hypertension and diabetes differed by ethnicity. Higher income was associated with lower odds of hypertension in AAs (aOR 0.86, 95{\%} CI 0.77–0.96) and ACs (aOR 0.55, 95{\%} CI 0.37–0.83). In AAs, those with some college education (aOR 0.79, 95{\%} CI 0.68–0.92) and college graduates (aOR 0.62, 95{\%} CI 0.53–0.73) had lower odds of hypertension than those with < high school education. In AIs, having health insurance was associated with higher odds of hypertension (aOR 1.59, 95{\%} CI 1.04–2.42) and diabetes (aOR 3.22, 95{\%} CI 1.29–8.04) diagnoses. We observed that the social determinants associated with hypertension and diabetes differed by ethnicity. Socioeconomic factors of health insurance and income were associated with a disparate prevalence of hypertension by ethnic group. Future research among Blacks should stratify by ethnicity to adequately address the contributors to health disparities.",
keywords = "Diabetes, Hypertension, Immigrants, Obesity, Race ethnicity",
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T1 - African Americans, African Immigrants, and Afro-Caribbeans Differ in Social Determinants of Hypertension and Diabetes

T2 - Evidence from the National Health Interview Survey

AU - Commodore-Mensah, Yvonne

AU - Matthie, Nadine

AU - Wells, Jessica

AU - B. Dunbar, Sandra

AU - Dennison-Himmelfarb, Cheryl Renee

AU - Cooper, Lisa A

AU - Chandler, Rasheeta D.

PY - 2017/12/12

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N2 - In the United States (U.S.), Blacks have higher morbidity and mortality from cardiovascular disease (CVD) than other racial groups. The Black racial group includes African Americans (AAs), African immigrants (AIs), and Afro-Caribbeans (ACs); however, little research examines how social determinants differentially influence CVD risk factors in each ethnic subgroup. We analyzed the 2010–2014 National Health Interview Survey, a cross-sectional, nationally representative survey of non-institutionalized civilians. We included 40,838 Blacks: 36,881 AAs, 1660 AIs, and 2297 ACs. Age- and sex-adjusted hypertension prevalence was 37, 22, and 21% in AAs, ACs, and AIs, respectively. Age- and sex-adjusted diabetes prevalence was 12, 10, and 7% in AAs, ACs, and AIs, respectively. In the multivariable logistic regression analyses, social determinants of hypertension and diabetes differed by ethnicity. Higher income was associated with lower odds of hypertension in AAs (aOR 0.86, 95% CI 0.77–0.96) and ACs (aOR 0.55, 95% CI 0.37–0.83). In AAs, those with some college education (aOR 0.79, 95% CI 0.68–0.92) and college graduates (aOR 0.62, 95% CI 0.53–0.73) had lower odds of hypertension than those with < high school education. In AIs, having health insurance was associated with higher odds of hypertension (aOR 1.59, 95% CI 1.04–2.42) and diabetes (aOR 3.22, 95% CI 1.29–8.04) diagnoses. We observed that the social determinants associated with hypertension and diabetes differed by ethnicity. Socioeconomic factors of health insurance and income were associated with a disparate prevalence of hypertension by ethnic group. Future research among Blacks should stratify by ethnicity to adequately address the contributors to health disparities.

AB - In the United States (U.S.), Blacks have higher morbidity and mortality from cardiovascular disease (CVD) than other racial groups. The Black racial group includes African Americans (AAs), African immigrants (AIs), and Afro-Caribbeans (ACs); however, little research examines how social determinants differentially influence CVD risk factors in each ethnic subgroup. We analyzed the 2010–2014 National Health Interview Survey, a cross-sectional, nationally representative survey of non-institutionalized civilians. We included 40,838 Blacks: 36,881 AAs, 1660 AIs, and 2297 ACs. Age- and sex-adjusted hypertension prevalence was 37, 22, and 21% in AAs, ACs, and AIs, respectively. Age- and sex-adjusted diabetes prevalence was 12, 10, and 7% in AAs, ACs, and AIs, respectively. In the multivariable logistic regression analyses, social determinants of hypertension and diabetes differed by ethnicity. Higher income was associated with lower odds of hypertension in AAs (aOR 0.86, 95% CI 0.77–0.96) and ACs (aOR 0.55, 95% CI 0.37–0.83). In AAs, those with some college education (aOR 0.79, 95% CI 0.68–0.92) and college graduates (aOR 0.62, 95% CI 0.53–0.73) had lower odds of hypertension than those with < high school education. In AIs, having health insurance was associated with higher odds of hypertension (aOR 1.59, 95% CI 1.04–2.42) and diabetes (aOR 3.22, 95% CI 1.29–8.04) diagnoses. We observed that the social determinants associated with hypertension and diabetes differed by ethnicity. Socioeconomic factors of health insurance and income were associated with a disparate prevalence of hypertension by ethnic group. Future research among Blacks should stratify by ethnicity to adequately address the contributors to health disparities.

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