Social Networks and Support,Gender, and Racial/Ethnic Disparities in Hypertension Among Older Adults |
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Authors: | Bridget K Gorman Jeremy R Porter |
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Institution: | (1) Department of Sociology MS28, Rice University, 6100 Main St., Houston, TX 77005-1892, USA;(2) City University of New York, New York, NY, USA |
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Abstract: | Using data from the 2001 NHIS and the 2005–2006 and 2007–2008 NHANES, we examine how self-reporting a previous diagnosis of
hypertension among adults aged 65+ differs by race/ethnicity for men and women; we explore the extent to which disparities
are driven by group differences in social risk factors, particularly social support and integration; and last, whether these
relationships mimic patterns seen for measured hypertension at interview. Findings indicate that rates of ever-diagnosed hypertension
in both samples are highest among black seniors and older women and lowest among Mexican-American men, with the gender gap
lowest among whites and substantially higher among blacks and Mexican-Americans. However, replication analyses of NHANES models
using measured hypertension, instead of a self-report of having ever been diagnosed with hypertension, suggests that reporting
bias and measurement error contribute to observed disparities, as racial/ethnic differences in hypertension rates are smaller
when measured hypertension is examined, especially among women. Logistic regression models also show that while adjusting
for group differences in measures of support and integration mediates some of the disparity in measured hypertension between
Mexican-American and white seniors, adjusting for support and integration amplifies black-white disparities in both ever diagnosed
and measured hypertension—driven primarily by adjustment for attendance at religious services, which reduces hypertension
risk for all older adults but is more commonly reported among black seniors, especially women. |
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