International Journal of Cardiology: Hypertension
Volume 2, 2019
Relationship between social determinants of health and systolic blood pressure in United States immigrants (Article) (Open Access)
Dawson A.Z. ,
Walker R.J. ,
Gregory C. ,
Egede L.E.*
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a
Department of Medicine, Division of General Internal Medicine, Medical College of Wisconsin, 9200 W. Wisconsin Ave., Milwaukee, WI 53226, United States, Center for Advancing Population Science, Medical College of Wisconsin, 8701 Watertown Plank Rd, Milwaukee, WI 53226, United States, College of Health Professions, Medical University of South Carolina, 151-A Rutledge Ave., MSC 960, Charleston, SC 29425, United States
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b
Department of Medicine, Division of General Internal Medicine, Medical College of Wisconsin, 9200 W. Wisconsin Ave., Milwaukee, WI 53226, United States, Center for Advancing Population Science, Medical College of Wisconsin, 8701 Watertown Plank Rd, Milwaukee, WI 53226, United States
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c
College of Health Professions, Medical University of South Carolina, 151-A Rutledge Ave., MSC 960, Charleston, SC 29425, United States
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d
Department of Medicine, Division of General Internal Medicine, Medical College of Wisconsin, 9200 W. Wisconsin Ave., Milwaukee, WI 53226, United States, Center for Advancing Population Science, Medical College of Wisconsin, 8701 Watertown Plank Rd, Milwaukee, WI 53226, United States
Abstract
This study examined the relationship between immigrant specific social determinants of health (SDoH) and blood pressure control. Data on 181 adult immigrants from the Midwestern United States was analyzed. SDoH variables were categorized based on antecedents, predisposing, enabling, and need factors. Systolic blood pressure (SBP) was the primary outcome. Pearson's correlations for the association between SBP and SDoH variables were assessed. Then three different regression approaches were used to assess the relationship of SDoH variables with SBP: sequential model, stepwise regression with backward selection, and all possible subsets regression. About 66% were female and mean age was 45.4 years. Age (r = 0.34, p < 0.001), disability (r = 0.20, p = 0.0001), comorbidities (r = 0.30, p < 0.001), and chronic pain (r = 0.12, p = 0.02) were positively correlated with SBP, and number of hours worked per week (r = −0.11, p = 0.028) was negatively correlated with SBP. The final sequential model found life-course socioeconomic status (SES) (β = 1.40, p = 0.039), age (β = 0.39, p < 0.001), and male sex (β = 13.62, p < 0.001) to be positively associated with SBP. Stepwise regression found that life-course SES (β = 1.70, p = 0.026), age (β = 0.36, p < 0.001), male sex (β = 13.38, p < 0.001), and homelessness as a child (β = 13.14, p = 0.034) were positively associated SBP. All possible subsets regression found that age (β = 0.44, p < 0.001), male sex (β = 14.50, p < 0.001), and homelessness as a child (β = 14.08, p = 0.027) were positively associated with SBP. This is the first study to use a theory-based model that incorporates social determinants of health and immigrant specific factors to examine the relationship between SDoH and blood pressure control and identifies potential targets for interventions to control BP in immigrants. Condensed abstract: The aim of this study was to examine the relationship between social determinants of health (SDoH) and blood pressure control in immigrants in the Midwestern United States. This study was conducted with 181 immigrants and found life-course SES, age, male sex, and being homeless as a child without a parent/guardian to be associated with systolic blood pressure. This is the first study to use a theory-based model that incorporates social determinants of health and immigrant specific factors to examine the relationship between SDoH and blood pressure control in immigrants. © 2019 The Authors
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Link
https://www.scopus.com/inward/record.uri?eid=2-s2.0-85070226762&doi=10.1016%2fj.ijchy.2019.100011&partnerID=40&md5=a6180a5282579cb90f83e61ef5690917
DOI: 10.1016/j.ijchy.2019.100011
ISSN: 25900862
Original Language: English