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Social Determinants of Health and Blood Pressure Control in Black and White Us Adults- [electronic resource]

자료유형: 학위논문파일 국외

최종처리일시: 20240214101208

ISBN: 9798380198813

DDC: 614.4

저자명: Akinyelure, Oluwasegun Philip.

서명/저자: Social Determinants of Health and Blood Pressure Control in Black and White Us Adults - [electronic resource]

발행사항: [S.l.]: : The University of Alabama at Birmingham., 2023

발행사항: Ann Arbor : : ProQuest Dissertations & Theses,, 2023

형태사항: 1 online resource(152 p.)

주기사항: Source: Dissertations Abstracts International, Volume: 85-03, Section: A.

주기사항: Advisor: Hardy, Shakia T.

학위논문주기: Thesis (Ph.D.)--The University of Alabama at Birmingham, 2023.

사용제한주기: This item must not be sold to any third party vendors.

초록/해제: 요약Black adults in the US have 2 to 3 times higher rates of cardiovascular disease (CVD) mortality compared to White adults. Most of the excess CVD mortality in Black adults has been attributed to their higher prevalence of hypertension and uncontrolled blood pressure (BP). In October 2020, the US Surgeon General published a Call-to-Action to improve hypertension control and identified social determinants of health (SDOH) as a major contributor to Black:White disparities in hypertension control. Prior research has showed that SDOH are associated with excess hypertension risk among Black compared with White adults, but data on their association with BP control are limited. In addition, few data are available on the association of SDOH with apparent treatment resistant hypertension (aTRH, the need for ≥4 classes of antihypertensive medications to achieve controlled BP). The goal of this dissertation was to (1) Examine the association of SDOH with uncontrolled BP among Black and White adults taking antihypertensive medication; (2) Determine the proportion of the excess prevalence of uncontrolled BP among Black compared to White adults taking antihypertensive medication that can be attributed to SDOH; (3) Determine the contribution of SDOH to the excess risk of incident aTRH among Black compared to White adults. Among both White (n=7,306) and Black adults (n=7,497) in the Reasons for Geographic And Racial Differences in Stroke study, SDOH including education, annual household income, neighborhood socioeconomic status, high-poverty zip code, lack of health insurance, and living in a health professional shortage area were each associated with uncontrolled BP. Combined, all SDOH included in the current analysis explained 33.0% of the excess likelihood of uncontrolled BP among Black compared with White adults. Among both White (n=2,774) and Black adults (n=2,257), low education (14.2%), low income (16.0%), not seeing a relative or friend in the past month (8.1%), not having anyone to care for you if ill (7.6%), living in a disadvantaged neighborhood (18.0%) and lack of health insurance (10.6%) mediated the excess aTRH risk among Black compared with White adults. Addressing SDOH could reduce racial disparities in uncontrolled BP and ultimately the excess CVD risk among Black adults.