268918 John Henryism and blood pressure among a multiethnic sample: The influence of socioeconomic position and occupational stressors

Sunday, October 28, 2012

Alana Wooley, MS , Department of Health Behavior and Health Education, University of Michigan School of Public Health, Ann Arbor, MI
Amy J. Schulz, PhD , Department of Health Behavior and Health Education, University of Michigan School of Public Health, Ann Arbor, MI
Graciela B. Mentz, PhD , Department of Health Behavior and Health Education, University of Michigan School of Public Health, Ann Arbor, MI
Denise White-Perkins, MD, PhD , Henry Ford Health System, Detroit, MI
Background. Blacks and Latinos experience excess risk of high blood pressure (HBP), a risk factor for cardiovascular disease, compared to Whites. John Henryism (JH), a high-effort coping strategy reflecting American values of hard work, may promote health across the lifespan when coupled with adequate resources. However, effortful coping in the context of occupational, social and economic disadvantage may contribute to HBP, exacerbating health inequalities. We examined associations between JH and HBP and patterning by socioeconomic position (SEP), race/ethnicity and occupational stressors.

Methods. The Healthy Environments Partnership Community Survey, conducted in 2002, includes 919 White, Black, and Latino adults aged >25. The dependent variable is HBP, defined as systolic blood pressure >120 mmHg or diastolic blood pressure >80 mmHg. The independent variable is the JH Active Coping Scale. SEP measures include poverty level, education, homeownership, and employment. Indicators of occupational stress include hours worked/week, weeks employed/year, job security, work demand, and work-family conflict.

Results. Latinos and Blacks; persons working high-skill discretion jobs; who work >40 hours/week; or who were employed year round had significantly higher JH. JH did not differ by SEP. Persons with high JH had 60% increased odds of HBP compared to persons with low JH, adjusting for poverty level (OR=1.60, 95% CI: 1.09, 2.36, p=0.02). Moderating effects of SEP and occupational factors will be explored.

Conclusions. This analysis may elucidate the influence of JH, SEP and occupational factors in racial/ethnic and socioeconomic health patterns. We discuss implications of these findings for public and occupational health over the lifecourse.

Learning Areas:
Advocacy for health and health education
Occupational health and safety
Public health or related research
Social and behavioral sciences

Learning Objectives:
By the end of the session the participant will be able to: Discuss how John Henryism, a high-effort coping strategy, may influence the risk of high blood pressure among marginalized populations. Assess the influence of socioeconomic position, race/ethnicity, and occupational stressors on efforts to improve the occupational, social, and economic opportunities and contexts for populations who experience excess risk for cardiovascular morbidity and mortality. Identify the practical implications of these findings on efforts to improve the health of vulnerable workers who experience excess risk of health inequalities.

Keywords: Hypertension, Workplace Stressors

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I have been involved in design of this analysis and conducted the statistical analysis of the community survey presented in this abstract. My co-authors include the PI of the study, statistician, and community partner.
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.