The silent killer disparities: race, gender and residence

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Published: Dec 6, 2012
DOI: https://doi.org/10.5750/ijpcm.v2i4.292
Keywords:
Gender healthcare disparities hypertension person-centered medicine race residence

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Jessica Barley
Medical University of South Carolina
Charles Ellis
Medical University of South Carolina

Abstract

Global estimates indicate that 26.4% of the worldwide adult population had hypertension (HTN) or the “silent killer” in 2000 and this number is predicted to increase to approximately 60% in 2025 to a total of 1.56 billion [1]. In the United States (US) alone, HTN occurs in 1 of 3 adults and more than 76 million Americans over the age of 20 have HTN [2]. Unfortunately, it has been established that 8% of the US population has undiagnosed HTN; a major risk factor for other chronic diseases such heart disease, stroke, congestive heart failure and kidney disease [3]. The financial burden associated with HTN is staggering, with costs approaching $77 billion dollars in the US in 2010, which included healthcare services, medications and missed days of work [4]. Thus, the direct and indirect health-related and financial burden is substantial. This Essay reviews the role of race, gender and residence in the creation of healthcare disparities focusing on the specific example of hypertension as a contribution to the debate on how person-centered care approaches can assist detection and treatment.

Article Details

Issue
Vol. 2 No. 4 (2012)
Section
Regular Articles

References

Kearney, P.M., Whelton, M., Reynolds, K., Muntner, P., Whelton, P.K. & He, J. (2005). Global burden of hypertension: analysis of worldwide data. Lancet 365 (9455) 217-223.

Fields, L.E., Burt, V.L., Cutler, J.A., Hughes, J., Roccella, E.J. & Sorlie, P. (2004). The burden of adult hypertension in the United States 1999 –2000: a rising tide. Hypertension 44, 398–404.

Fryar, C.D., Hirsch, R., Eberhardt, M.S., Yoon, S.S. & Wright, J.D. (2010). Hypertension, high serum total cholesterol, and diabetes: racial and ethnic prevalence differences in U.S. adults, 1999–2006. NCHS Data Brief 36 April 2010.

World Health Organization. (2011). www.who.int. Web 19 November 2011.

Chobanian, A.V., Bakris, G.L., Black, H.R., Cushman, W.C., Green, L.A., Izzo, J.L. Jr., Jones, D.W., Materson, B.J., Oparil, S., Wright, J.T. Jr., Roccella, E.J. & Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure, National Heart, Lung, and Blood Institute, National High Blood Pressure Education Program Coordinating Committee. (2003). Seventh report of the Joint National Committee on Prevention, Detection, Evaluation and Treatment of High Blood Pressure. Hypertension 42, 1206–1252.

Glasser, S.P., Judd, S., Basile, J., Lackland, D., Halanych, J., Cushman, M., Prineas, R., Howard, V. & Howard, G. (2011). Prehypertension, racial prevalence and its association with risk factors: Analysis of the REasons for Geographic And Racial Differences in Stroke (REGARDS) study. American Journal of Hypertension 24 (2) 194-199.

Kramer, H., Han, C., Post, W., Goff, D., Diez-Roux, A., Cooper, R., Jinagouda, S. & Shea, S. (2004). Racial/ethnic differences in hypertension and hypertension treatment and control in the multi-ethnic study of atherosclerosis (MESA). American Journal of Hypertension 17 (10) 963-970.

Pleis, J.R., Ward, B.W. & Lucas, J.W. (2010). Summary health statistics for U.S. adults: National Health Interview Survey, 2009. Vital and Health Statistics 10 (249). Available at: http://www.cdc.gov/nchs/data/series/sr_10/sr10_249.pdf. Accessed November 19, 2011.

Kressin, N.R., Orner, M.B., Manze, M., Glickman, M.E. & Berlowitz, D. (2010). Understanding contributors to racial disparities in blood pressure control. Circulation: Cardiovascular Quality and Outcomes 3 (2) 173-180.

Howard, G., Prineas, R., Moy, C., Cushman, M., Kellum, M., Temple, E., Graham, A. & Howard, V. (2006). Racial and geographic differences in awareness, treatment, and control of hypertension: the Reasons for Geographic and Racial Differences in Stroke Study. Stroke 37, 1171–1178

Bosworth, H.B., Dudley, T., Olsen, M.K., Voils, C.I., Powers, B., Goldstein, M.K. & Oddone, E.Z. (2006). Racial differences in blood pressure control: potential explanatory factors. American Journal of Medicine 119 (1) 70 e9-15.

LaVeist, T. (2005). Minority Populations and Health: An Introduction to Health Disparities in the United States. San Francisco: Josey-Bass.

Centers for Disease Control and Prevention. (2009). Prevalence and trends data. In: Behavioral Risk Factor Surveillance System Data. Atlanta, Ga: US Department of Health and Human Services, Centers for Disease Control and Prevention. Available at: http://apps.nccd.cdc.gov/brfss/index.asp. Accessed November 19, 2011.

Fiscella, K. & Holt, K. (2008). Racial disparity in hypertension control: tallying the death toll. Annals of Family Medicine. 6 (6) 497-502.

Wong, M.D., Shapiro, M.F., Boscardin, W.J. & Ettner, S.L. (2002). Contribution of major diseases to disparities in mortality. New England Journal of Medicine 347 (20) 1585-1592.

Gu, Q., Burt, V.L., Paulose-Ram, R. & Dillon, C.F. (2008). Gender differences in hypertension treatment, drug utilization patterns, and blood pressure control among US adults with hypertension: data from the National Health and Nutrition Examination Survey 1999-2004. American Journal of Hypertension. 21 (7) 789-798.

Federal Interagency Forum on Aging-Related Statistics. (2010). Older Americans 2010 Key Indicators of Well-Being: Federal Interagency Forum on Aging-Related Statistics. Washington, DC: US Government Printing Office. Available at: http://www.agingstats.gov. Accessed November 19, 2011.

National Center for Health Statistics. (2010). Health, United States, 2009: With Special Feature on Medical Technology. Hyattsville, Md: National Center for Health Statistics. Available at: http://www.cdc.gov/nchs/data/hus/hus09.pdf. Accessed Novmeber 19, 2011.

Crescioni, M., Gorina, Y., Bilheimer, L. & Gillum, R. (2010). Trends in health status and health care use among older men. National Health Statistics Reports, No. 24. Hyattsville, Md: National Center for Health Statistics.

King, K.E., Morenoff, J.D. & House, J.S. (2011). Neighborhood context and social disparities in cumulative biological risk factors. Psychosomatic Medicine 73 (7) 572-579.

Waidmann, T.A. & Rajan, S. (2000). Race and ethnic disparities in health care access and utilization: an examination of state variation. Medical Care Research & Review 57 (Supplement 1) 55-84.

Mainous, A.G. 3rd., King, D.E., Garr, D.R. & Pearson, W.S. (2004). Race, rural residence, and control of diabetes and hypertension. Annals of Family Medicine 2 (6) 563-568.

Ellis, C., Grubaugh, A.L. & Egede, L.E. (2010). The effect of minority status and rural residence on actions to control high blood pressure in the U.S. Public Health Reports 125 (6) 801-809.

Mujahid, M.S., Diez-Roux, A.V., Cooper, R.C., Shea, S. & Williams, D.R. (2011). Neighborhood stressors and race/ethnic differences in hypertension prevalence (the Multi-Ethnic Study of Atherosclerosis). American Journal of Hypertension 24 (2) 187-193.

Lukoschek, P. (2003). African Americans' beliefs and attitudes regarding hypertension and its treatment: a qualitative study. Journal of Health Care for the Poor and Underserved 14 (4) 566-587.

Lopez-Ruiz, A., Sartori-Valinotti, J., Yanes, L.L., Iliescu, R. & Reckelhoff , JjF. (2008). Sex differences in control of blood pressure: role of oxidative stress in hypertension in females. American Journal of Physiology Heart and Circulatory Physiology 295, H466-474.

Merchant, J., Coussens, C. & Gibert, D., eds. (2006). Rebuilding the Unity of Health and the Environment in Rural America. Washington, DC: The National Academies Press.

Klimentidis, Y.C., Dulin-Keita, A., Casazza, K., Willig, A.L., Allison, D.B. & Fernandez, J.R. (2012). Genetic admixture, social-behavioural factors and body composition are associated with blood pressure differently by racial-ethnic group among children. Journal of Human Hypertension 26 (2) 98-107.

Miles, A. & Mezzich, J.E. (2011). The care of the patient and the soul of the clinic: person-centered medicine as an emergent model of modern clinical practice. International Journal of Person Centered Medicine 1 (2) 207-222.

Hicken, M., Gragg, R. & Hu, H. (2011). How cumulative risks warrant a shift in our approach to racial health disparities: the case of lead, stress, and hypertension. Health Affairs (Millwood) 30,1895-1901.

Kressin, N.R., Wang, F., Long, J., Bokhour, B.G., Orner, M.B., Rothendler, J., Clark, C., Reddy, S., Kozak, W., Kroupa, L.P. & Berlowitz, D.R. (2007). Hypertensive patients' race, health beliefs, process of care, and medication adherence. Journal of General Internal Medicine 22 (6) 768-774.

Glasser, S.P., Judd, S., Basile, J., Lackland, D., Halanych, J., Cushman, M., Prineas, R., Howard, V. & Howard. G. (2011). Prehypertension, racial prevalence and its association with risk factors: Analysis of the REeasons for Geographic And Racial Differences in Stroke (REGARDS) study. American Journal of Hypertension 24 (2) 194-199.

Miles, A. & Mezzich, J.E. (2012). Person-centered medicine: addressing chronic illness and promoting future health. International Journal of Person Centered Medicine 2 (2) 149-152.