Hopkins Center for Health Disparities Solutions, Johns Hopkins School of Public Health, Baltimore, MD, USA.
University of Maryland, College Park, MD, USA.
J Urban Health. 2020 Apr;97(2):250-259. doi: 10.1007/s11524-020-00421-1.
In the US, African Americans have a higher prevalence of hypertension than Whites. Previous studies show that social support contributes to the racial differences in hypertension but are limited in accounting for the social and environmental effects of racial residential segregation. We examined whether the association between race and hypertension varies by the level of social support among African Americans and Whites living in similar social and environmental conditions, specifically an urban, low-income, racially integrated community. Using data from the Exploring Health Disparities in Integrated Communities-Southwest Baltimore (EHDIC-SWB) sample, we hypothesized that social support moderates the relationship between race and hypertension and the racial difference in hypertension is smaller as the level of social support increases. Hypertension was defined as having systolic blood pressure greater than 140 mmHg and/or diastolic blood pressure greater than 90 mmHg, or the participant reports of taking antihypertensive medication(s). The study only included participants that self-reported as "Black/African American" or "White." Social support was measured as functional social support and marital status. After adjusting for demographics and health-related characteristics, we found no interaction between social support and race (DUFSS score, prevalence ratio 1.00; 95% confidence interval 0.99, 1.01; marital status, prevalence ratio 1.02; 95% confidence interval 0.86, 1.21); thus the hypothesis was not supported. A plausible explanation is that the buffering factor of social support cannot overcome the social and environmental conditions which the participants live in. Further, these findings emphasize social and environmental conditions of participants in EHDIC-SWB may equally impact race and hypertension.
在美国，非裔美国人的高血压患病率高于白人。先前的研究表明，社会支持有助于解释高血压的种族差异，但无法充分说明种族居住隔离的社会和环境影响。我们研究了在社会和环境条件相似的情况下，生活在城市低收入、种族融合社区中的非裔美国人和白人的社会支持水平是否会影响种族与高血压之间的关联，以及这种关联是否会因社会支持水平的不同而有所差异。我们利用来自探索综合社区健康差异-巴尔的摩西南部（EHDIC-SWB）样本的数据，假设社会支持会调节种族与高血压之间的关系，并且随着社会支持水平的提高，种族间高血压的差异会减小。高血压的定义为收缩压大于 140mmHg 和/或舒张压大于 90mmHg，或参与者报告正在服用抗高血压药物。该研究仅包括自我报告为“黑人/非裔美国人”或“白人”的参与者。社会支持用功能社会支持和婚姻状况来衡量。在调整人口统计学和健康相关特征后，我们没有发现社会支持与种族之间存在交互作用（DFUSS 评分，患病率比为 1.00；95%置信区间为 0.99，1.01；婚姻状况，患病率比为 1.02；95%置信区间为 0.86，1.21）；因此，该假设不成立。一个合理的解释是，社会支持的缓冲因素无法克服参与者所处的社会和环境条件。此外，这些发现强调了 EHDIC-SWB 参与者的社会和环境条件可能同样会对种族和高血压产生影响。
