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A Closer Look at African American Men and High Blood Pressure Control

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A Closer Look at African American Men and High Blood Pressure Control A Review of Psychosocial Factors and Systems-Level Interventions A Closer Look at African American Men and High Blood Pressure Control U.S. Department of Health and Human Services Centers for Disease Control and Prevention National Center for Chronic Disease Prevention and Health Promotion Centers for Disease Control and Prevention National Center for Chronic Disease Prevention and Health Promotion Division for Heart Disease & Stroke Prevention Mail Stop K–47 · 4770 Buford Highway, NE · Atlanta, Georgia 30341 800-CDC-INFO · [email protected] · www.cdc.gov/DHDSP 10_211234-A Suggested Citation: Centers for Disease Control and Prevention. A Closer Look at African American Men and High Blood Pressure Control: A Review of Psychosocial Factors and Systems-Level Interventions. Atlanta: U.S. Department of Health and Human Services; 2010. Photos: The photographs used in this publication are for illustration purposes only. They show African American men from various age groups. They are not intended to depict people who have high blood pressure or who had a heart attack or stroke. For Free Copies or Additional Information: E-mail: [email protected] Write: Division for Heart Disease and Stroke Prevention, NCCDPHP Centers for Disease Control and Prevention 4770 Buford Highway, NE, Mailstop K-47 Atlanta, GA 30341 Phone: 1-800-CDC-INFO (232-4636) TTY: 1-888-232-6348 Online: http://www.cdc.gov/dhdsp The findings and conclusions in this document are those of the author(s) and do not necessarily represent the official position of the Centers for Disease Control and Prevention/the Agency for Toxic Substances and Disease Registry. Table of Contents Chapter Page Acknowledgments.......................................................................................................................................3 Top 10 Considerations for Public Health Programs When Planning Systems-Level Interventions for African American Men to Control High Blood Pressure.......................................................................5 Recommendations ......................................................................................................................................6 Preface ........................................................................................................................................................9 Chapter 1 - Introduction ..........................................................................................................................13 Chapter 2 - The Burden of High Blood Pressure.......................................................................................15 2.1 Overview ......................................................................................................................................... 16 2.2 Morbidity ........................................................................................................................................ 16 2.2.1 Elevated Blood Pressure ........................................................................................................ 16 2.2.2 Hypertension Awareness, Treatment, and Control ................................................................ 17 2.2.3 Heart Disease ....................................................................................................................... 19 2.2.4 Stroke ................................................................................................................................... 20 2.3 Mortality ......................................................................................................................................... 20 2.3.1 Death Rates from Hypertensive Disease................................................................................ 20 2.3.2 Death Rates from Heart Disease ........................................................................................... 23 2.3.3 Death Rates from Cerebrovascular Disease ........................................................................... 24 Chapter 3 - Psychosocial Aspects of Blood Pressure Control among African American Men ....................27 3.1 Overview ......................................................................................................................................... 27 3.2 Perceived Racism, Experienced Racism, and Racial Discrimination ................................................. 27 3.3 Knowledge, Beliefs, and Attitudes about Hypertension.................................................................... 29 3.4 Access to Care ................................................................................................................................. 30 3.5 Health Insurance ............................................................................................................................. 30 3.6 Quality of Care................................................................................................................................ 31 3.7 Socioeconomic Status ...................................................................................................................... 32 3.8 Rural Residence ............................................................................................................................... 33 3.9 Social Support ................................................................................................................................. 34 3.10 Depression ...................................................................................................................................... 34 3.11 Substance Abuse .............................................................................................................................. 35 3.12 Obesity ............................................................................................................................................ 35 3.13 Emerging Knowledge about Disparities in Hypertension ................................................................. 36 a review to address blood pressure control in african american men 1 Chapter 4 - Programs with Systems-Level Interventions ...........................................................................37 4.1 Overview ......................................................................................................................................... 37 4.2 Summary of Lessons Learned .......................................................................................................... 38 4.2.1 Overall Lessons ..................................................................................................................... 38 4.2.2 Lessons on Program Participation by African American Men ................................................ 39 4.2.3 Lessons on Cultural Competency ......................................................................................... 40 4.3 Interviewed Programs ...................................................................................................................... 40 4.3.1 Examples of Program Models ............................................................................................... 40 4.3.2 Interviewed Programs Matrix ................................................................................................ 42 4.3.3 Individual Program Summaries ............................................................................................. 43 4.4 Literature Search Results .................................................................................................................. 80 4.4.1 Journal Article Projects Matrix .............................................................................................. 81 4.4.2 Blood Pressure Control Programs Focusing on African American Men ................................. 83 4.4.3 Blood Pressure Control/Coronary Heart Disease Prevention Programs Focusing on the African American Community ......................................................................................................... 90 4.4.4 Other Relevant Systems-Level Health Care Programs Focusing on the African American Community ......................................................................................................... 99 Chapter 5 - General Health Resources ....................................................................................................105 5.1 Overview .......................................................................................................................................... 105 References ...............................................................................................................................................117 Appendix A – Key Terms and Phrases Used to Find Programs or Interventions for African American Men with High Blood Pressure in the Practice Literature ....................................................................................... 123 Appendix B – Key Terms Used to Find Peer-Reviewed Articles Relevant to Systems-Level Interventions for African American Men with High Blood Pressure .................................................................................. 125 2 african american men and blood pressure control: a closer look Acknowledgments This project was supported by a task order contract (200-2001-00123) between RTI International and the Division for Heart Disease and Stroke Prevention (DHDSP), National Center for Chronic Disease Prevention and Health Promotion (NCCD­ PHP), Centers for Disease Control and Prevention (CDC). 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