Date of Conferral

2022

Degree

Ph.D.

School

Public Health

Advisor

Loretta Sheilds

Abstract

Prehypertension (PreHTN) is a significant risk factor for hypertension (HTN) that has been observed in both pediatric and adult populations. In the United States, adjusted mortality rate attributed to HTN in 2018 was highest among non-Hispanic Black (NHB) men followed by NHB females. The purpose of this study was to measure whether lowest, middle, and highest poverty group (LMHPG) and PreHTN varied by age, gender, race, and ethnicity (Hispanic compared to non-Hispanic [HcNH]) and whether the association varied by participants responding yes or no to having been told by a doctor or healthcare professional that they have PreHTN. This study, guided by a critical race theory (CRT) framework, used secondary data from the 2007–2008 National Health and Nutrition Examination Survey database (n = 4,939). Logistic regression and chi-square test of association were performed. There was a statistically significant association between LMHPG and PreHTN X2 (df = 4,939) = 8.684, p-value = < .013). Being in the HPG compared to LPG favored increased odds of 44% (p < .010) for PreHTN. A within-race subanalysis revealed that being NHB in the HPG was a significant predictor of PreHTN (OR 1.50, 90% CI [1.049, 2.152], p = < .062) compared to non-Hispanic White (NHW) and other race categories. The prospect for social change from this research comes from evidence that being in the HPG is a risk factor for PreHTN. This adds evidence of the need to go beyond traditional public health interventions (e.g., individual level) that tend to use race-neutral approaches and leverage tertiary-level prevention (e.g., public policy) such as reparations to American descendants of slavery and Baby Bonds to address the core roots of poverty and minimize its harmful effects.

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