142nd APHA Annual Meeting and Exposition

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Framing Hypertension Risk and Disparities: A Case Study on Social and Political Actors Perceptions of the Role of Living Conditions in a Colombian Municipality

142nd APHA Annual Meeting and Exposition (November 15 - November 19, 2014): http://www.apha.org/events-and-meetings/annual
Tuesday, November 18, 2014

Diego Lucumi Cuesta, MD, MPH, PhD (c) , Department of Health Behavior and Health Education, School of Public Health University of Michigan, Silvania, Colombia
Amy J. Schulz, PhD , Department of Health Behavior and Health Education, University of Michigan School of Public Health, Ann Arbor, MI
Barbara Israel, DrPH MPH , Department of Health Behavior and Health Education, University of Michigan, School of Public Health, Ann Arbor, MI
Background: At the municipal level, social and political actors play a key role in influencing the social patterning of health and disease in their jurisdictions through enacting and implementing policies. These policies usually respond to problems that are socially constructed based on the identification and interpretation of issues as problematic. Therefore, understanding how these actors frame problems is a critical step in examining opportunities to address hypertension risks and disparities at the local level.

Data and Methods.  Using a critical case sampling strategy, Quibdó, the capital and largest municipality of the department/state of Chocó (Colombia), was selected to conduct a qualitative single-case study. The population of Quibdó is115,052, 92% of whom are Afro-Colombians.  The percentage of poverty in Quibdó is 89.5%, and cardiovascular disease is the leading cause of mortality in population aged 45 years and over. Based on stratified purposive sampling, 13 participants from four strata were selected: community leaders, municipal officials, policymakers, and health practitioners. Through individual interviews participants answered questions regarding the tasks of the framing theory: diagnostic, prognostic, and actors. Data were analyzed using the Framework approach.

Results & Implications. Participants identified that unemployment, unplanned urban space, and displacement, in combination with processes of stratification and marginalization shape living conditions of residents of Quibdó and influence HT risk and disparities. Participants prioritized policies to increase economic opportunities, regulate urban planning, and improve access to public services and physical infrastructure. This study highlights the relevance of examining local actors’ frames for understanding complex issues in their jurisdictions.

Learning Areas:

Chronic disease management and prevention
Public health or related education
Public health or related research
Social and behavioral sciences

Learning Objectives:
Identify how social and political actorsí perspectives on risk and disparities in hypertension emerge from the complex intersection of social determinants and processes that shape living conditions of urban dwellers. Describe the type of public policies and interventions that social and political actors consider relevant to address risk and disparities in hypertension in their jurisdiction.

Keyword(s): Health Disparities/Inequities, Urban Health

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I have training and working experience in cardiovascular disease prevention. This abstract is based on one of the studies I conducted as part of my doctoral dissertation.
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.