Social environment may play a greater role in the
disparity between the numbers of African-
Americans living with hypertension compared to non-Hispanic
whites with the disease. A study by
researchers at the Johns
Hopkins Bloomberg School of Public Health found that
the disparity was
substantially reduced when comparing groups of
African-Americans and non-Hispanic whites living in
similar social environments. The results are published in
the November print edition of Social Science
and Medicine.
"Our study found that nearly 31 percent of the
hypertension disparity among African-
Americans and non-Hispanic whites is attributable to
environmental factors," said Roland James
Thorpe Jr., lead author of the study and an assistant
scientist with the Center for Health Disparities
Solutions at the Bloomberg School. "These findings show
that ethnic disparities could be linked to a
number of factors other than race. Careful review of
psychosocial factors, stress, coping strategies,
discrimination and other personality characteristics could
play a large role in reducing or eliminating
the disparity."
Commonly referred to as the "silent killer,"
hypertension is the most common cardiovascular
disease, affecting 65 million adults in the United States.
Hypertension is a serious condition that can
damage the heart and blood vessels and eventually lead to
stroke, heart failure, heart attack, kidney
failure and vision problems. Previous studies have found
that African-Americans tend to have an
earlier onset and higher prevalence of the disease than
non-Hispanic whites.
Thorpe, along with colleagues from the Center for
Health Disparities Solutions and North
Carolina Central University, compared data from the
Exploring Health Disparities in the Integrated
Communities study and the National Health and Nutrition
Examinations Survey to determine if racial
disparities in hypertension persisted in communities where
there is a minimal difference in social
environments. The EHDIC study examines racial disparities
among African-Americans and non-
Hispanic whites with the same median socioeconomic status
who reside in the same community.
NHANES, a cross-sectional survey, reviews the health,
function and nutritional status of people in the
United States.
"After adjusting for demographic variables, our
research found that while African-Americans
still displayed greater odds of being hypertensive compared
to non-Hispanic whites, there was a
dramatic decrease in the ratio. Our study concluded that
race differences in social and environmental
exposures partially accounted for race differences in
hypertension," said Thomas LaVeist, senior
author of the study and director of the Center for Health
Disparities Solutions. "These findings
support our theory that the disparity is likely caused by
environmental factors along with several
external factors and not biological differences among race
groups, as previously suspected."
The study was written by Thorpe, Dwayne T. Brandon and
LaVeist.
The researchers were funded by grants from the
National Center on Minority Health, Health
Disparities of the National Institutes of Health and
Pfizer.
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