“A Silent Killer”: How Zambian Immigrants in a Midwestern State Explain Hypertension

Purpose: Studies on Explanatory Models (EMs) for hypertension among populations of African descent in the US have mostly been conducted on African Americans. The purpose of this study was to examine EMs for hypertension among Zambian immigrants in Indiana.

Methods: Twenty-two semi-structured interviews were conducted with Zambian immigrants between December 2009 and January 2010. The interviews were conducted in English and guided by five general questions. Participants were also asked to complete a demographic survey. The interviews were transcribed and analyzed using content analysis, while survey data were analyzed using descriptive frequency.

Results: Participants had a median age range of 36-45 years and the average length of stay in the US was 12 years. Sixteen participants had health insurance and females represented sixty four percent of the participants. Participants described hypertension as high blood pressure and referred to it as 'BP'. Major themes for causes of hypertension centered on fatty American foods, stress, lack of exercise, and food high in salt content. Some identified stressors included medical bills, supporting extended family members in Zambia, and rearing children in America. Women were more aware about hypertension in their social networks and were more likely to have been diagnosed with hypertension than men. Men feared becoming dependent on anti-hypertensive medication more than women.

Conclusion: Hypertension was perceived as a serious health problem in the Zambian immigrant community, especially among women because of their role of holding the family together. There was a desire for hypertension awareness programs in the Zambian immigrant community.