Odame Emmanuel A, Atandoh Paul H, Mamudu Lohuwa, Adzrago David, Tagoe Ishmael, Sulley Saanie, Boms Maureen, Tetteh-Bator Erasmus, McNeel Timothy S, Williams Faustine
Department of Environmental Health Sciences, School of Public Health, University of Alabama at Birmingham, Birmingham, AL, USA.
Department of Mathematics, Mercer University, Macon, GA, USA.
Prev Med Rep. 2023 Nov 23;36:102523. doi: 10.1016/j.pmedr.2023.102523. eCollection 2023 Dec.
With the increasing prevalence of hypertension-related cardiovascular deaths and depression, this study examined the associations of depression with hypertension, citizenship status, and interaction of hypertension and citizenship status among U.S. adults. Data from the 2015-2018 National Health Interview Survey (NHIS), including 63,985 individuals, were analyzed. Depression status was the outcome, with hypertension and U.S. citizenship status as the main independent variables. Using odds ratio (OR) estimates, we evaluated the associations between hypertension and depression, and citizenship status. The result indicates that a higher proportion of U.S. adults with hypertension reported depression compared to those who did not have hypertension (42.9 % vs. 37.5 %). In terms of U.S. citizenship status, a higher proportion of U.S. citizens reported depression than non-citizens (39.6 % vs. 31.6 %). However, non-citizens with hypertension were more likely to report depression compared to U.S. citizens without hypertension (OR = 1.46; 95 % CI = 1.15, 1.86). While hypertension marginally increased the odds of depression among the general U.S. population, being a non-U.S. citizen with hypertension significantly increased the risk of depression by 46 %. The findings imply that the healthy immigrant paradox, in the context of hypertension-depression prevention and control, may not apply to non-citizens with hypertension. We therefore recommend community-based screenings and more tailored interventions to address these health disparities while taking into consideration the unique cultural norms, behaviors and healthcare barriers encountered by specific immigrant communities.
随着高血压相关心血管死亡和抑郁症患病率的不断上升，本研究调查了美国成年人中抑郁症与高血压、公民身份以及高血压与公民身份之间的相互作用之间的关联。对2015 - 2018年国家健康访谈调查（NHIS）的数据进行了分析，该数据涵盖63985人。以抑郁症状态为结果变量，高血压和美国公民身份作为主要自变量。通过比值比（OR）估计，我们评估了高血压与抑郁症以及公民身份之间的关联。结果表明，与没有高血压的美国成年人相比，患有高血压的美国成年人中报告有抑郁症的比例更高（42.9%对37.5%）。就美国公民身份而言，美国公民中报告有抑郁症的比例高于非公民（39.6%对31.6%）。然而，患有高血压的非公民比没有高血压的美国公民更有可能报告有抑郁症（OR = 1.46；95%置信区间 = 1.15, 1.86）。虽然高血压在一般美国人群中略微增加了患抑郁症的几率，但作为患有高血压的非美国公民，患抑郁症的风险显著增加了46%。研究结果表明，在高血压 - 抑郁症的预防和控制背景下，健康移民悖论可能不适用于患有高血压的非公民。因此，我们建议开展基于社区的筛查和更具针对性的干预措施，以解决这些健康差异问题，同时考虑到特定移民社区所面临的独特文化规范、行为和医疗保健障碍。
