The Association Between State Characteristics and Latinx People's Treated Hypertension in Established and New Latinx Destination States: A Multilevel Analysis.

IF 1.5 4区 医学 Q3 FAMILY STUDIES Family & Community Health Pub Date : 2024-04-01 DOI:10.1097/FCH.0000000000000393
Adriana Maldonado, Helena H Laroche, Daniel K Sewell, Rima Afifi, Richard M Hoffman, Barbara Baquero, Paul A Gilbert
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Abstract

This study sought to quantify the contributions of state-level factors including income inequality, state's legislature political control, and Medicaid expansion in new and established Latinx destination states on Latinx individuals' treated hypertension. Mixed-effects logistic regression analyses were conducted to analyze 2017 Behavioral Risk Factor Surveillance System data from 7524 Latinx adults nested within 39 states. Overall, 70% reported being pharmacologically treated for hypertension, and 66% resided in established destination states. Compared with Latinx people in established destination states, Latinx people in new destinations had lower odds of having treated hypertension (odds ratio [OR] = 0.72, 95% CI = 0.54-0.95). Within established Latinx destinations, the odds of treated hypertension were lower in states where legislatures expanded Medicaid than in states that did not expand Medicaid (OR = 0.84, 95% CI = 0.79-0.89). However, after controlling for the effects of individual-level factors, this association was no longer statistically significant. In new Latinx destination states, Medicaid expansion, legislatures' political control, and income inequality were not associated with treated hypertension. The study results highlight the importance of considering both individual- and state-level factors, as the interplay of such factors could hinder the successful implementation of cardiovascular risk reduction interventions.

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既定和新的拉美裔目的地州的州特征与拉美裔人接受治疗的高血压之间的关系:多层次分析
本研究试图量化州一级因素(包括收入不平等、州立法机构的政治控制以及新的和已建立的拉美裔目的地州的医疗补助扩展)对拉美裔个人接受治疗的高血压的贡献。研究人员对嵌套在 39 个州内的 7524 名拉美裔成年人的 2017 年行为风险因素监测系统数据进行了混合效应逻辑回归分析。总体而言,70%的人报告接受过高血压药物治疗,66%的人居住在成熟的目的地州。与既定目的地州的拉美裔相比,新目的地的拉美裔接受过高血压治疗的几率较低(几率比 [OR] = 0.72,95% CI = 0.54-0.95)。在已确定的拉美裔目的地州中,立法机构扩大医疗补助计划的州比未扩大医疗补助计划的州治疗高血压的几率更低(OR = 0.84,95% CI = 0.79-0.89)。然而,在控制了个人因素的影响后,这种关联不再具有统计学意义。在新的拉丁裔目的地州,医疗补助扩展、立法机构的政治控制和收入不平等与治疗高血压无关。研究结果强调了同时考虑个人和州层面因素的重要性,因为这些因素的相互作用可能会阻碍降低心血管风险干预措施的成功实施。
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来源期刊
CiteScore
2.70
自引率
4.30%
发文量
69
期刊介绍: Family & Community Health is a practical quarterly which presents creative, multidisciplinary perspectives and approaches for effective public and community health programs. Each issue focuses on a single timely topic and addresses issues of concern to a wide variety of population groups with diverse ethnic backgrounds, including children and the elderly, men and women, and rural and urban communities.
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