Addressing Hypertension Disparities: A Comprehensive Approach for African American Communities in Alexandria

Introduction

In order to provide effective mitigation strategies for hypertension cases among African American communities in Alexandria, it is essential to assess the needs of the population. Understanding where the people's needs are not met is useful for the planning, allocation, and deployment of resources necessary for mitigating hypertensive disorders within the community. The population needs assessment helps identify any niche where the needs of a target population are not met, thus allowing prioritization of response efforts. It is, therefore, crucial to consider demographic data, prevalence, and risk factor information from the target population, and it is upon these that this section of the study focuses upon

Demographic Data

There have been numerous recorded cases of disparities between different racial groups with regards to hypertension as well as related conditions. The differences lean heavily to the disadvantage of African Americans, with over thirty-two percent of its population afflicted with hypertension. Additionally, the number accounts for over twenty-seven percent of all cases of uncontrollable cardiovascular pressure. Essentially, African Americans have an 8.6% greater prevalence of hypertension than Americans of European descent (Booth et al., 2017). Studies have also shown that the percentage of people requiring pharmacotherapy treatment for hypertension is higher among African Americans than among other races, including Mexican Americans and others.

Risk Factors

Among the identified risk factors associated with hypertension include diabetes and obesity. In fact, hypertension is often known to lead to type 2 diabetes, and the two conditions are closely related. 20% to 60% of patients with diabetes are at risk of developing hypertension according to studies, an indication of the comorbidity of these two conditions. In this scope, diabetes type 2 is three times as prevalent among African Americans than it is among those of European descent. Some genetic as well as environmental and social factors influence this disparity and lead to exposing African American communities to a greater risk of developing hypertension (Fryar et al., 2017).

Obesity, on the other hand, is associated with rising cholesterol levels in the body and is also a significant risk factor for hypertension and other cardiovascular conditions (Commodore-Mensah et al., 2018). In Alexandria, much like in many other African American communities, around 37% of patients that come into the hospital for hypertension treatment are also treated for obesity as a secondary condition.

Methodology

Much of the information for the population needs assessment has been collected from local and national health databases. The data is further reinforced by interviews of fellow caregivers and medical practitioners in the local area who testified to the data mentioned earlier within the scope of their practice. The interviews also served to help create a more personal look to the data to identify factors such as socioeconomic and environmental influence on the comorbidity of hypertension and other conditions mentioned above.

Priority Health Issues

As previously discussed, hypertension is often associated with various comorbid conditions such as type 2 diabetes and obesity. Additionally, these conditions have equal or even greater prevalence than hypertension, especially among African American communities. In this regard, any mitigation strategy for hypertension cannot afford to ignore the two conditions- type 2 diabetes and obesity due to their comorbidity.

Additional issues to prioritize while addressing hypertension as a health issue include the different socioeconomic and environmental dispositions that increase the risk of hypertension. It is crucial to analyze these issues holistically in order to mitigate against hypertension on a community scale. They also provide the framework for sensitization as a mitigation strategy and especially when dealing with comorbidities associated with hypertension like obesity.

Health Program Plan

In order to mitigate against hypertension among African Americans in Alexandria, it is essential to develop a health program plan based on the Plan-Do-Check-Act (PDCA) framework, as highlighted below.

Plan

The model is a continuous iterative cycle that begins with formulating a plan based on information obtained from the previous action. It involves studying the last activity to identify need gaps. From the previous discussion, priority issues include addressing both type 2 diabetes and obesity as part of the mitigation strategy, in addition to better understanding the socioeconomic underpinnings that influence the conditions.

Do

This stage of the model calls for the execution of the previous section's proposals with emphasis on better holistic treatment for comorbid conditions associated with hypertension. Therapy should also focus on caregivers' sensitization when dealing with obesity scenarios, especially among African American communities for effective mitigation.

Check/Study

At this point, the study calls for an evaluation of the impact of the 'doings' of the previous stage to ascertain the effectiveness of the proposed mitigation strategy. It also calls for the identification of any weak links in the plan, depending on the impact upon the patients. Questions to ask may include whether sensitization of caregivers has an effect on the treatment and how best to address comorbidities on a ‘big-picture’ perspective

Act

With the fine-tuned evaluation results of the previous stage, the plan then calls for further action to fulfill any conditions that were identified as crucial to the mitigation process. It calls for the implementation of the answers to the questions of the previous stage.

Interventions

The most pragmatic primary intervention strategy for hypertension is lifestyle adjustment. Lifestyle adjustment strategies help to improve the patient’s health as well as prevent comorbidities such as obesity by minimization of risks from overindulgence of certain foods and substances.

Secondary intervention strategies include the sensitization of caregivers when dealing with African Americans with obesity to create a trusting relationship necessary for effective mitigation. This is necessary for the regular blood pressure measurement sessions that form part of the intervention strategy.

With regard to tertiary intervention, empowerment health behavior has been shown to significantly improve the quality of treatment for hypertension by reinforcing constructive, healthy behaviors among patients of hypertension. Research by Wannaprapa et al. (2012) shows that empowerment health behavior is associated with reinforced lifestyle discipline necessary for adjustment and consistent recovery.

Conclusion

Hypertension is a serious community health issue that has a disproportionate degree of prevalence among African American communities in Alexandria and the USA at large. The prevalence of hypertension is associated with comorbid conditions such as obesity and diabetes, making it imperative that a mitigation strategy takes a holistic approach to address the comorbidity. Other socioeconomic and environmental risk factors associated with hypertension also call for sensitization among caregivers to create a trusting, and therefore significant medical relationship. The study thus calls for a holistic intervention strategy that promotes a healthy lifestyle, ensures a healthy relationship between patients and caregivers as well as reinforcing healthy behavior through the community.

References

Wannaprapa, Bundit & Pansila, Wirat & Tansakul, Chalermpol & Shelp, Frank-Peter (2012). Tertiary Prevention of Hypertension Through Empowerment Health Behavior of Ambulatory Patients at Selected Primary Care Units of Nakhonratchasima Province, Thailand. Pakistan Journal of Social Sciences. 9. 63-68. 10.3923/pjssci.2012.63.68.

Fryar, C. D., Ostchega, Y., Hales, C. M., Zhang, G., & Kruszon-Moran, D. (2017). Hypertension prevalence and control among adults: the United States, 2015-2016.

Commodore-Mensah, Y., Selvin, E., Aboagye, J., Turkson-Ocran, R. A., Li, X., Himmelfarb, C. D., ... & Cooper, L. A. (2018). Hypertension, overweight/obesity, and diabetes among immigrants in the United States: an analysis of the 2010–2016 National Health Interview Survey. BMC Public Health, 18(1), 1-10.

Booth III, J. N., Li, J., Zhang, L., Chen, L., Muntner, P., & Egan, B. (2017). Trends in prehypertension and hypertension risk factors in US adults: 1999–2012. Hypertension, 70(2), 275-284.