242954 Getting control of hypertension: Social determinants of treatment and control

Tuesday, November 1, 2011

Jennifer A. Hartfield, PhD(c), MPH, MCHES , Department of Health Behavior and Health Education, University of Michigan, Ann Arbor, MI
Amy J. Schulz, PhD , School of Public Health, Department of Health Behavior and Health Education, University of Michigan, Ann Arbor, MI
Graciela B. Mentz, PhD , Department of Health Behavior and Health Education, University of Michigan, Ann Arbor, MI
Denise White Perkins, MD, PhD , Institute on Multicultural Health, Henry Ford Health System, Detroit, MI
Background: Hypertension is a major risk factor for cardiovascular disease, a leading cause of death for Americans that accounts for one-third of the mortality disparity between non-Hispanic Black and non-Hispanic White Americans. In previous research, we found higher rates of hypertension prevalence, but lower rates of awareness, treatment and control, among residents of Detroit, Michigan when compared to the United States. Non-Hispanic Blacks were more likely to be aware of their hypertension, but paradoxically, had lower treatment and control rates than non-Hispanic White Detroit residents. Data and Methods. We build on previous findings to examine individual (e.g., household income) and neighborhood level (e.g., neighborhood poverty level) predictors of hypertension treatment and control. Data are from a two-stage random probability sample of Detroit residents (≥25 years), conducted by the Detroit Healthy Environments Partnership, a community-based participatory research partnership. Two level hierarchical linear models test the hypothesis that neighborhood socioeconomic characteristics (e.g., percent below poverty) are associated with prevalence, awareness, treatment and control of hypertension among non-Hispanic Blacks, non-Hispanic Whites and Latinos, and that these associations partially account for lower rates of treatment and control among non-Hispanic Blacks. Results & Implications. Results from these analyses inform priorities for intervention by identifying characteristics of urban residential neighborhoods associated with effectiveness of hypertension treatment and control. We discuss implications for public health efforts to control hypertension, with attention to social determinants of treatment and control among non-Hispanic Black residents of low to moderate income urban communities.

Learning Areas:
Other professions or practice related to public health
Public health or related education
Public health or related research
Social and behavioral sciences

Learning Objectives:
1. Identify potential neighborhood characteristics and conditions that may influence the hypertension awareness, treatment and the effectiveness of control. 2.Describe public health strategies for intervening to improve the effectiveness of hypertension control,with particular attention to addressing lower rates of treatment and control among non-Hispanic Black Americans.

Keywords: Health Disparities, Hypertension

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I am qualified to present because I have over 10 years of experience managing programs such as disease prevention and health education programs.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.