Race, gender, and hypertension among low-income adults in west Tennessee

BACKGROUND: The apparent links between race, gender, and hypertension have been widely recognized as scientists often use race or gender as independent variables in prevalence studies. As such, it has been difficult to determine whether environmental, psychosocial, behavioral, and health status measures are related to hypertension in the same way for all racial groups. This study examined the extent to which factors correlated with hypertension vary across four race-and gender-specific groups.

METHODS: This study used surveillance data collected over two years (2001-2002) from individuals attending primary care clinics in Shelby County, Tennessee to estimate pooled and group-specific regression models. The primary dependent variable was a self-report measure of hypertension drawn from a survey item asking respondents if they had ever been diagnosed with high blood pressure. Independent variables included socioeconomic, psychosocial, health behavior, and health status measures generally thought to be associated with hypertension.

RESULTS: The pooled analysis indicated that hypertension status was associated with a number of the demographic, health behavior, and health status factors. However, once race- and gender-specific models were estimated, the results showed that the factors associated with hypertension varied considerably for black men, white men, black women, and white women. The group-specific regression models revealed and disentangled important correlations not observed in the pooled model.

CONCLUSIONS: The findings suggest that addressing racial disparities in blood pressure-related outcomes requires health practitioners to modify prevention and treatment efforts to incorporate a broader array of factors inherent to specific racial and gender populations.