Social context as an explanation for race disparities in hypertension: Findings from the Exploring Health Disparities in Integrated Communities (EHDIC) Study

Thorpe, Roland J.; Brandon, Dwayne T.; LaVeist, Thomas A.

doi:10.1016/j.socscimed.2008.07.002

Cited by 104 publications

(99 citation statements)

References 46 publications

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“…27 In fact, prior EHDIC analyses found minimal racial disparities in hypertension, obesity and diabetes, and those findings are largely attributable to relatively high disease prevalence in whites. [28][29][30] Secondly, income, which is a consistent predictor of hypertension elsewhere, 27,31 was not associated with blood pressure levels or with risk of hypertension in this sample. This is likely because the community mean income is near the poverty threshold and there is little variability in income, so poverty exposure is homogeneous within the sample.…”

Section: Discussionmentioning

confidence: 57%

Community Characteristics are Associated with Blood Pressure Levels in a Racially Integrated Community

Samuel

Thorpe²,

Bower³

et al. 2015

J Urban Health

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Community problems have been associated with higher, and community resources and social cohesion with lower, blood pressure. However, prior studies have not accounted for potential confounding by residential racial segregation. This study tested associations between community characteristics and blood pressure levels and prevalent hypertension in a racially integrated community. The Exploring Health Disparities in Integrated Communities Study measured blood pressure in residents of two contiguous racially integrated and low-income US Census Tracts. Community characteristics included a standardized community problem score and binary indicators for community social cohesion, having a community leader available, and having at least one community resource observed on the participant's block. In adjusted models, greater community problems and proximity to resources were associated with lower systolic (β=−2.020, p=0.028; β=−4.132, p=0.010) and diastolic (β=−1.261, p=0.038; β=−2.290, 0.031) blood pressure, respectively, among whites (n=548). Social cohesion was associated with higher systolic (β=4.905, p=0.009) and diastolic blood pressure (β=3.379, p=0.008) among African Americans (n=777). In one racially integrated lowincome community, community characteristics were associated with blood pressure levels, and associations differed by race. Directions of associations for two findings differed from prior studies; greater community problem was associated with lower blood pressure in whites and community social cohesion was associated with higher blood pressure in African Americans. These findings may be due to exposure to adverse environmental conditions and hypertensive risk factors in this low-income community.

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Section: Discussionmentioning

confidence: 57%

Community Characteristics are Associated with Blood Pressure Levels in a Racially Integrated Community

Samuel

Thorpe²,

Bower³

et al. 2015

J Urban Health

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“…28,29 In addition to self-concepts, social identity and perceptions of bias shape individual behavior and may impact both interpersonal relationships and interactions with social institutions to compromise health at the individual level. For example, individuals may identify negative interactions with clinicians to be culturally insensitive, perceive restricted access to quality health care as institutional racism, and view this hardship as discrimination.…”

Section: Nia Health Disparities Research -Hill Et Almentioning

confidence: 99%

The National Institute on Aging Health Disparities Research Framework

et al. 2015

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Objective: Development of a new framework for the National Institute on Aging (NIA) to assess progress and opportunities toward stimulating and supporting rigorous research to address health disparities.Design: Portfolio review of NIA’s health disparities research portfolio to evaluate NIA’s progress in addressing priority health disparities areas. Results: The NIA Health DisparitiesResearch Framework highlights important factors for health disparities research related to aging, provides an organizing structure for tracking progress, stimulates opportunities to better delineate causal pathways and broadens the scope for malleable targets for intervention, aiding in our efforts to address health disparities in the aging population. Conclusions: The promise of health disparitiesresearch depends largely on scientific rigor that builds on past findings and aggressively pursues new approaches. The NIA Health Disparities Framework provides a landscape for stimulating interdisciplinary approaches, evaluating research productivity and identifying opportunities for innovative health disparities research related to aging. Ethn Dis. 2015;25(3):245-254.

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“…This can pose a significant problem when relying on national data to understand and inform men's health disparities. 17,[20][21][22] There are three explanations for these findings. First, the EHDIC study design represents an opportunity to begin to disentangle race and residential segregation to better understand health disparities among men.…”

Section: Discussionmentioning

confidence: 99%

Disentangling Race and Social Context in Understanding Disparities in Chronic Conditions among Men

et al. 2014

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Disparities in men's health research may inaccurately attribute differences in chronic conditions to race rather than the different health risk exposures in which men live. This study sought to determine whether living in the same social environment attenuates race disparities in chronic conditions among men. This study compared survey data collected in 2003 from black and white men with similar incomes living in a racially integrated neighborhood of Baltimore to data from the 2003 National Health Interview Survey. Multivariable logistic regression models estimated to determine whether race disparities in chronic conditions were attenuated among men living in the same social environment. In the national sample, black men exhibited greater odds of having hypertension (odds ratio [OR]=1.58, 95 % confidence interval [CI] 1.34, 1.86) and diabetes (OR=1.62, 95 % CI 1.27-2.08) than white men. In the sample of men living in the same social context, black and white respondents had similar odds of having hypertension (OR=1.05, 95 % CI 0.70, 1.59) and diabetes (OR=1.12, 95 % CI 0.57-2.22). There are no race disparities in chronic conditions among low-income, urban men living in the same social environment. Policies and interventions aiming to reduce disparities in chronic conditions should focus on modifying social aspects of the environment.

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Social context as an explanation for race disparities in hypertension: Findings from the Exploring Health Disparities in Integrated Communities (EHDIC) Study

Cited by 104 publications

References 46 publications

Community Characteristics are Associated with Blood Pressure Levels in a Racially Integrated Community

Community Characteristics are Associated with Blood Pressure Levels in a Racially Integrated Community

The National Institute on Aging Health Disparities Research Framework

Disentangling Race and Social Context in Understanding Disparities in Chronic Conditions among Men

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