Association of race consciousness with the patient-physician relationship, medication adherence, and blood pressure in urban primary care patients

LaPrincess C. Brewer, Kathryn Anne Carson, David R. Williams, Allyssa Allen, Camara P. Jones, Lisa A Cooper

Research output: Contribution to journalArticle

Abstract

BACKGROUND: Race consciousness (the frequency with which one thinks about his or her own race) is a measure that may be useful in assessing whether racial discrimination negatively impacts blood pressure (BP). However, the relation between race consciousness and BP has yet to be empirically tested, especially within the context of the patient-physician relationship and medication adherence.

METHODS: Race-stratified generalized estimating equations were used to assess the relationship of race consciousness on BP, measures of the patient-physician relationship, and self-reported medication adherence, controlling for patients being nested within physicians and for patient age and sex.

RESULTS: The mean age of the patients was 61.3 years, 62% were black, and 65% were women. Black patients were more likely to ever think about race than were white patients (49% vs. 21%; P <0.001). Race-conscious blacks had significantly higher diastolic BP (79.4 vs. 74.5 mm Hg; P = 0.004) and somewhat higher systolic BP (138.8 vs. 134.7 mm Hg; P = 0.13) than blacks who were not race conscious. Race-conscious whites were more likely to perceive respect from their physician (57.1% vs. 25.8%; P = 0.01) but had lower medication adherence (62.4% vs. 82.9%; P = 0.05) than whites who were not race-conscious.

CONCLUSIONS: Among blacks, race consciousness was associated with higher diastolic BP. In contrast, among whites, there was no association between race consciousness and BP, but race consciousness was associated with poor ratings of adherence, despite more favorable ratings of the patient-physician relationship. Future work should explore disparities in race consciousness and its impact on health and health-care disparities.

Original languageEnglish (US)
Pages (from-to)1346-1352
Number of pages7
JournalAmerican Journal of Hypertension
Volume26
Issue number11
DOIs
StatePublished - Nov 1 2013

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Physician-Patient Relations
Medication Adherence
Consciousness
Primary Health Care
Blood Pressure
Hypertension
Race Relations
Healthcare Disparities
Physicians
Racism

Keywords

  • adherence
  • blood pressure
  • blood pressure discrimination
  • disparities
  • hypertension
  • perceived quality of care
  • race
  • racism.

ASJC Scopus subject areas

  • Medicine(all)

Cite this

Association of race consciousness with the patient-physician relationship, medication adherence, and blood pressure in urban primary care patients. / Brewer, LaPrincess C.; Carson, Kathryn Anne; Williams, David R.; Allen, Allyssa; Jones, Camara P.; Cooper, Lisa A.

In: American Journal of Hypertension, Vol. 26, No. 11, 01.11.2013, p. 1346-1352.

Research output: Contribution to journalArticle

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