Relationship between social determinants of health and systolic blood pressure in United States immigrants

Q4 Medicine International Journal of Cardiology: Hypertension Pub Date : 2019-08-01 DOI:10.1016/j.ijchy.2019.100011

Aprill Z. Dawson , Rebekah J. Walker , Chris Gregory , Leonard E. Egede

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引用次数: 7

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.

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美国移民健康社会决定因素与收缩压的关系

本研究考察了移民特定健康社会决定因素(SDoH)与血压控制之间的关系。研究人员分析了来自美国中西部的181名成年移民的数据。SDoH变量根据前因、易感因素、使能因素和需求因素进行分类。收缩压(SBP)是主要终点。评估收缩压和SDoH变量之间的Pearson相关性。在此基础上，采用顺序模型、逐步回归和全可能子集回归三种不同的回归方法来评估SDoH变量与SBP的关系。其中女性约占66%，平均年龄45.4岁。年龄(r = 0.34, p <0.001)、残疾(r = 0.20, p = 0.0001),并发症(r = 0.30, p & lt;慢性疼痛(r = 0.12, p = 0.02)与收缩压呈正相关，每周工作时间(r = - 0.11, p = 0.028)与收缩压呈负相关。最终的序列模型发现，生命历程社会经济地位(SES) (β = 1.40, p = 0.039)、年龄(β = 0.39, p <0.001)，男性(β = 13.62, p <0.001)与收缩压呈正相关。逐步回归发现,人生SES(β= 1.70,p = 0.026),年龄(β= 0.36,p & lt;0.001)，男性(β = 13.38, p <0.001)，儿童时期无家可归(β = 13.14, p = 0.034)与收缩压呈正相关。所有可能的子集回归发现年龄(β = 0.44, p <0.001)，男性(β = 14.50, p <0.001)，儿童时期无家可归(β = 14.08, p = 0.027)与收缩压呈正相关。这是第一个使用基于理论的模型的研究，该模型结合了健康的社会决定因素和移民特定因素来检查SDoH和血压控制之间的关系，并确定了控制移民血压的干预措施的潜在目标。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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