Introduction
Hypertension is a major health hazard that has been prioritized by the public health sector in many countries. All around the globe, hypertension has led to increased cardiovascular diseases and contributed to the death of many people across all races and ages. Although every race is affected by hypertension, some have reported more cases than others. According to Spikes et al. (2019), approximately 46% of all Americans are affected by hypertension. African Americans are the most affected group with a 46.3 % and 45% prevalence for men and women respectively (Spikes et al.,2019). This demonstrates that the higher burden of hypertension borne by African Americans has led to poor health conditions and higher mortality rates. Hypertension management is dependent on multiple factors including healthy beliefs, adherence to medication, social support, and depression. This research addresses the cultural factors influencing hypertension prevalence and management among African Americans using the available scholarly research journals. This paper aims to show that African Americans’ perceptions, attitudes, and cultural attributes contribute significantly to the high mortality rates attributed to hypertension.
Current Statistics on Hypertension Prevalence
Globally, hypertension prevalence studied over the years has shown the presence of racial and gender disparities. In a study by Long et al. (2017), non-Hispanic blacks in the U.S. have a higher age-adjusted death rate compared to other races. In reference to heart diseases, 210.4 deaths out of 100,000 involve African Americans (Long et al., 2017). The geographical study also shows that states dominated by African Americans have reported the highest number of deaths from stroke and various heart conditions, all of which are attributed to hypertension and hyperlipidemia. South Carolina and Georgia are some of the states with at least 25% of the population consisting of African Americans (Long et al., 2017). The study also reveals that African Americans are twice as likely to suffer and die from stroke and heart diseased compared to other races. Although the study was conducted in America, it can be replicated in other parts of the world. This proves the disproportionate burden of hypertension faced by African Americans.
Global Factors Explaining the Racial Disparities
Hypertension prevalence can be influenced by various factors, some within and others without the control of individuals. In history, African Americans have faced various challenges that have left them more exposed and at a higher risk of hypertension than other groups. The most significant factor is racism and discrimination, which has existed since the pre-colonial period. In the U.S. discrimination against non-native Americans led to an increase in poverty which is a major factor contributing to hypertension (Long et al., 2017). Discrimination also limits access to health care, further contributing to a higher prevalence of hypertension. Over the years, African Americans have been subjected to social stressors that have exposed them to hypertension risk and also minimized their self-care and management capabilities (Spikes et al.,2019). The cultural perspectives of African Americans have influenced their hypertension management practices, implying that there is a strong link between psychosocial factors and hypertension control among African Americans.
Health Beliefs, Medical Adherence and Social Support Among African Americans
Every culture has a set of beliefs and values that influence their attitudes towards disease and consequently affect their disease control and management practices. In their study, Spikes et al. (2019) adopted the health belief model (HBM) to unveil the connection between medication adherence and cultural attributes. According to their research, various discordant health views and beliefs about hypertension have significantly increased the prevalence of the condition and limited control measures among many ethnic groups (Spikes et al., 2019). African Americans hold diverse health beliefs on hypertension that are contrary to those of medical practitioners. Their attitudes regarding hypertension susceptibility and severity have influenced adherence to medication giving rise to the huge disparity in hypertension prevalence between African Americans and other groups (Spikes et al., 2019). The HBM theory explains the different behavioral attributes that determine how people control and manage hypertension.
Knowledge acquisition and application is a crucial factor to consider in reviewing medical adherence among African Americans. According to the research by Long et al. (2017), many African Americans believe that they are more likely to have high blood pressure. Their discordant health beliefs explain why most have refused to engage in healthy practices recommended by health practitioners. Smoking cessation, adherence to medication, and eating healthy diets especially those aimed at increasing the health of the heart have been cited as the most important factors that improve health conditions among African Americans (Long et al., 2017). Despite this awareness, many African Americans have avoided counseling on smoking cessation. One of the factors contributing to the increased hesitance among African American men is the need for control. Most of them feel that following the diet regulations and medications implies control over their freedom, an element that is not welcome among them.
Social support is another factor that may limit individuals’ engagement in healthy practices. Many African Americans face the social support challenge whereby the family demand s limit their access and ability to purchase the recommended food products and supplements (Long et al., 2017). Low economic status, discrimination, and lack of social support have made it difficult for African Americans with hypertension to manage their conditions, adding to the high mortality rates. The work culture among African Americans also aggravates the issue. It is common to find families with only one breadwinner, increasing their financial burden and inhibiting their healthy eating access and abilities. With their low incomes, it would be difficult for many African Americans to invest in healthcare insurance. This makes their treatment difficult because most of them cannot raise the expected amount. This factor coupled with the culture focused on traditional treatment methods contributes to high mortality rates caused by hypertension among African Americans.
In society, men and women have been raised to embrace different roles, that also determine how they handle medical issues. In the African American culture, men are more affected by hypertension than women (Spikes et al., 2019). The disparity can be explained by increased mistrust in the healthcare sector among men. Many African American men believe in self-medication and would rather use traditional methods than seek medical advice. This cultural fact has significantly limited their interaction with medical practitioners and reduced their involvement in healthy behaviors that could lower their blood pressure. Social pressures are also significantly higher among African American men than in women, further contributing to the disparity noted by Long et al. (2017). From these findings, it is clear that Culture and personal behavioral practices have intertwined to increase the hypertension prevalence among African Americans.
Hypertension Management Among African Americans
Self-management is one of the most effective ways of managing hypertension, stroke, and resultant heart diseases. Long et al. (2017) studied self-management among African American men with a focus on open communication uninfluenced by cultural beliefs, masculinity, and management perceptions. Their study included in-person focus study groups comprised of males aged 40-65 years from the African Americans -dominated regions (Long et al., 2017). Their findings showed that most men knew that they were more susceptible to hypertension but their knowledge did not translate into effective self-care methods. One crucial point noted in this research is that some men believed that medication affected their sexual capabilities, an issue greatly influenced by masculinity and cultural values.
Implications Of the Study
In view of the above findings, there is a need to establish effective community-based methods of addressing hypertension among African-Americans. The first tool noted by Long et al. (2017) is peer-to-peer communication. In their interview, they discovered that men were more willing to communicate when in peer-to-peer focus groups led by men. In this case, it would be essential to establish a model that would encourage open discussions on hypertension challenges among African American men. This would facilitate the development of viable solutions reducing the prevalence and severity of the disease.
To deal with the discordant health perceptions among African Americans, healthcare providers should understand the health beliefs and promote understanding among African Americans. If most of them understood the real implications of hypertension and the value of self-care, they would be more willing to engage in health management programs without feeling that their freedom is breached. Social support programs should also be included to promote inclusivity and create connections that would facilitate hypertension prevention and control programs.
Depending on the perpetuated cultural values, men tend to be less adherent to medication than women. The study conducted by Spikes et al. (2019) was comprised of women, mostly young and earning. The results showed that the majority of the participants reported good medication adherence. It can be noted that having an income and sufficient knowledge on hypertension and the available self-care management practices promotes medication adherence a shown in the study (Spikes et al., 2019). The link between social support and depression was also reported in this study. Availability of social support limited depressive symptoms among participants leading to reduced instances of hypertension (Spikes et al., 2019). Therefore, early treatment of depression can be cited as one of the hypertension prevention strategies.
Conclusion
In conclusion, hypertension has become a critical issue in the medical field. Although it affects people of all ages, gender, and race, its effects vary depending on cultural values, health beliefs, and medication adherence. This research paper has addressed hypertension prevalence and control among African Americans with a particular focus on the cultural factors involved. From the articles cited, it is shown that hypertension is more prevalent among African American men than in other cultural settings. Many African Americans hold discordant beliefs about the health system, having less faith in the healthcare sector, and are less adherent to medication. Besides, most have been hesitant of following self-care and hypertension management programs due to low income, discrimination, and personal perspectives. This challenge can be handled by involving social support, promoting education, and using peer-to-peer focus groups to facilitate open communication.
References
Long, E., Ponder, M., & Bernard, S. (2017). Knowledge, attitudes, and beliefs related to hypertension and hyperlipidemia self-management among African-American men living in the southeastern United States. Patient education and counseling, 100(5), 1000–1006. Web.
Spikes, T., Higgins, M., Quyyumi, A., Reilly, C., Pemu, P., & Dunbar, S. (2019). The relationship among health beliefs, depressive symptoms, medication adherence, and social support in African Americans with hypertension. The Journal of cardiovascular nursing, 34(1), 44–51. Web.