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Social Networks and Support, Gender, and Racial/Ethnic Disparities in Hypertension Among Older Adults

机译:老年人高血压的社交网络与支持,性别和种族/种族差异

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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.
机译:利用2001年NHIS和2005-2006年以及2007-2008年NHANES的数据,我们研究了65岁以上成年人中自我报告的先前诊断为高血压的种族和民族之间的差异。我们探讨了社会风险因素尤其是社会支持和融合中的群体差异导致差异的程度;最后,这些关系是否模仿面试时测得的高血压的模式。研究结果表明,在两个样本中,黑人老年人和年长女性的高血压诊断率最高,而墨西哥裔美国人的最低,白人之间的性别差距最低,黑人和墨西哥裔美国人的性别差距明显更高。但是,使用测得的高血压进行的NHANES模型复制分析,而不是曾经被诊断出患有高血压的自我报告,表明报告的偏倚和测量误差会导致观察到的差异,因为测得的高血压时,种族/族裔的高血压比率差异较小被检查,特别是在妇女中。 Logistic回归模型还显示,在调整支持和整合措施的群体差异时,可以调和墨西哥裔美国人和白人老年人之间测得的高血压之间的某些差异,而对支持和整合进行的调整会放大曾经诊断和测得的高血压中的黑白差异。 -主要是通过调整参加宗教活动的机会来进行的,这降低了所有老年人的高血压风险,但在黑人老年人尤其是女性中更为普遍。

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