Date of Conferral

2021

Degree

Doctor of Public Health (DrPH)

School

Public Health

Advisor

Chester Jones

Abstract

Black individuals in the United States are twice as likely as White individuals to die of cardiovascular diseases. Between 2010 and 2016 in Arkansas (AR), hypertension (HTN) and HTN-related diseases had an age-adjusted death rate of 230.4 deaths per 100,000 population compared to 173.6 deaths per 100,000 population for Whites. The purpose of this quantitative, cross-sectional study was to explore the potential association between HTN self-awareness and emergency department (ED) visits and hospitalization rates for HTN and HTN-related illnesses between Black and White individuals in AR. The socioecological framework was used to explore sociodemographic (SDF) and socioeconomic (SES) factors as drivers of racial health disparities in the state. The Behavioral Risk Factor Surveillance System and AR Hospital Discharge Database were secondary data, and binary logistic regression and Chi-square analyses were used to examine the differences between HTN self-awareness and ED visits and hospitalizations for HTN and HTN-related diseases between Black and White adults in the state. The study results were statistically significant and showed that Black adults were 77.9% less likely to be aware of their HTN status and twice as likely to be unaware when controlling for SDF and SES (N = 27,438). They were also more likely to visit the ED (27.5%) and be admitted (53.0%) for HTN and HTN-related illnesses even when confounding for SDF and comorbidities. Eliminating racial disparities in HTN awareness will require targeted and intentional mechanisms that directly address health inequities. Equity-based, community-oriented, and individualized interventions and policies can reduce disparities, advance health equity, and promote positive social change.

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