Neighborhood and social influences on blood pressure: An exploration of causation in the explanatory models of hypertension among African Americans

Objective: African Americans are at the highest risk of having hypertension compared to all other races and ethnicities in the United States. This disparity is compounded by lower rates of medication adherence and blood pressure control among African Americans. Divergence in African American patients’ views of their hypertension from the biomedical model may be an important driver in shaping adherence behaviors and outcomes. Our study sought to identify African American explanatory models (EMs) of hypertension with a focus on disease etiology, in order to increase provider understanding of how African American patients conceptualize their hypertension and how this information can be used to foster provider-patient trust and engagement.