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

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

Research output: Contribution to journalArticle

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) ≥ 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.

Original languageEnglish (US)
Pages (from-to)1604-1611
Number of pages8
JournalSocial Science and Medicine
Volume67
Issue number10
DOIs
StatePublished - Nov 1 2008

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Keywords

  • Confounding race and socioeconomic status (SES)
  • Hypertension
  • Integrated community
  • Racial disparities
  • Residential segregation
  • USA

ASJC Scopus subject areas

  • Health(social science)
  • History and Philosophy of Science

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