TY - JOUR
T1 - Social context as an explanation for race disparities in hypertension
T2 - Findings from the Exploring Health Disparities in Integrated Communities (EHDIC) Study
AU - Thorpe, Roland J.
AU - Brandon, Dwayne T.
AU - LaVeist, Thomas A.
N1 - Funding Information:
This research was supported by grant # P60MD000214-01 from the National Center on Minority Health and Health Disparities (NCMHD) of the National Institutes of Health (NIH), and a grant from Pfizer, Inc. Dr. Thorpe was supported by a training grant from the National Institute on Aging (T32AG000120) and contract from the National Center for Minority Health and Health Disparities Loan Repayment Program.
PY - 2008/11
Y1 - 2008/11
N2 - 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) ≥ 140 mmHg (millimeters of mercury) and/or diastolic BP ≥ 90 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.
AB - 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) ≥ 140 mmHg (millimeters of mercury) and/or diastolic BP ≥ 90 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.
KW - Confounding race and socioeconomic status (SES)
KW - Hypertension
KW - Integrated community
KW - Racial disparities
KW - Residential segregation
KW - USA
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U2 - 10.1016/j.socscimed.2008.07.002
DO - 10.1016/j.socscimed.2008.07.002
M3 - Article
C2 - 18701200
AN - SCOPUS:52949146729
SN - 0277-9536
VL - 67
SP - 1604
EP - 1611
JO - Social Science and Medicine
JF - Social Science and Medicine
IS - 10
ER -