McClintock Heather F, Peacock Victoria, Nkiri Asong Rose
Department of Public Health, College of Health Sciences, Arcadia University, Glenside, PA, USA.
Department of Health and Human Performance, The Leahy College of Health Science, University of Scranton, Scranton, PA, USA.
J Hum Hypertens. 2025 Feb;39(2):148-154. doi: 10.1038/s41371-024-00945-y. Epub 2024 Aug 17.
Hypertension is a leading modifiable risk factor for morbidity and mortality among women in Sub-Saharan Africa. Social determinants of health (SDH) are associated with sex-based differences in access to preventative screenings globally. Little research has assessed the influence of SDH on screening for hypertension among women in The Gambia. The aim of this study was to identify SDH associated with the utilization of hypertension screening among women in The Gambia. Data was examined from the 2019-2020 Gambia Demographic and Health Survey. Weighted multivariate logistic was used to identify whether SDH were associated with hypertension screening. Among 4116 women, over one-fifth (21.1%) had not been screened for hypertension in their lifetime. In fully adjusted models, older age, rural residence, higher than secondary educational attainment, employment, identification with specific ethnic groups, richer wealth status, parity (1 or more), and antenatal care visits increased the likelihood of lifetime hypertension screening. Women who indicated that others made their healthcare decisions for them (partners or someone else) were significantly less likely to have been screened for hypertension in their lifetime than women who made their healthcare decisions alone (adjusted odds ratio = 0.552, 95% confidence interval = (0.384-0.794)). SDH influence access to screening for hypertension among women in The Gambia. Initiatives may need to address the role of SDH to improve access and uptake of hypertension screening.
高血压是撒哈拉以南非洲地区女性发病和死亡的主要可改变风险因素。全球范围内，健康的社会决定因素（SDH）与获得预防性筛查的性别差异相关。很少有研究评估SDH对冈比亚女性高血压筛查的影响。本研究的目的是确定与冈比亚女性高血压筛查利用相关的SDH。数据来自2019 - 2020年冈比亚人口与健康调查。采用加权多变量逻辑回归来确定SDH是否与高血压筛查相关。在4116名女性中，超过五分之一（21.1%）一生中未接受过高血压筛查。在完全调整模型中，年龄较大、居住在农村、教育程度高于中学、就业、属于特定种族群体、财富状况较好、生育次数（1次或更多）以及产前检查次数增加了一生中进行高血压筛查的可能性。表示由他人（伴侣或其他人）为其做出医疗保健决策的女性，一生中接受高血压筛查的可能性显著低于自己做出医疗保健决策的女性（调整后的优势比 = 0.552，95%置信区间 =（0.384 - 0.794））。SDH影响冈比亚女性获得高血压筛查的机会。可能需要采取措施解决SDH的作用，以改善高血压筛查的可及性和接受率。
