Quantifying the Associations Between Social Determinants of Health and Blood Pressure 1-3 Years Following Pregnancy in Black Women.

Abstract

Objective: Examine the association between social determinants of health (SDOH) (cultural, neighborhood, and physical factors) and blood pressure (BP) in Black women 1-3 years following delivery.

Methods: Cross-sectional data collected from N=204 adult Black women who had a live delivery between 2013 and 2022 in Milwaukee, Wisconsin, USA, were analyzed. Sequential linear and logistic regression models were run to test associations between SDOH variables and systolic and diastolic BP. SDOH were the independent variables; systolic and diastolic BP were the outcome variables. Stepwise linear and logistic regression with forward selection were run to assess the independent associations between SDOH and BP in Black women 1-3 after pregnancy.

Results: Mean systolic and diastolic BP were 120.1 (± 17.4 SE) and 82.0 (± 13.2 SE), respectively. In final stepwise regression models, age (β 0.61, 95% CI 0.20, 1.02), income (β 5.45 95% CI 0.35, 10.56), chance health locus of control (β -0.78, 95% CI -1.37, -0.19), depression (β 0.59, 95% CI 0.10, 1.08), BMI (β 0.33, 95% CI 0.08, 0.57), family history of preeclampsia (β 7.92, 95% CI 1.49, 14.35), and kidney disease (β 60.32, 95% CI 38.71, 81.93) were associated with systolic BP. Age (β 0.53, 95% CI 0.23, 0.83), depression (β 0.55, 95% CI 0.22, 0.87), BMI (β 0.45, 95% CI 0.28, 0.63), family history of preeclampsia (β 5.71, 95% CI 0.97, 10.45), and kidney disease were significantly associated with diastolic BP.

Conclusion: Depression was associated with increased systolic BP and chance health locus of control was associated with decreased systolic BP. Depression was significantly associated with increased diastolic BP. Future research should explore causal mechanisms between depression and hypertension risk.