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Many individuals with untreated high diastolic blood pressure (DBP) do not seek medical care. This lack of healthcare access persists even after referral, highlighting a critical gap in hypertension management.
Area of Science:
- Public Health
- Cardiovascular Health
- Health Disparities
Background:
- Hypertension is a significant public health concern, particularly in rural and underserved communities.
- Understanding barriers to medical care access is crucial for effective hypertension management.
- Previous research indicates disparities in healthcare utilization among different demographic groups.
Purpose of the Study:
- To investigate the association between medical care utilization and diastolic blood pressure (DBP) in a rural Southern biracial community.
- To identify factors contributing to the nonuse of medical care among individuals with untreated hypertension.
- To assess healthcare-seeking behaviors following referral for elevated blood pressure.
Main Methods:
- Cross-sectional study involving 2,939 individuals from a rural Southern biracial community.
- Data collected through surveys on medical care use (physician visits in the preceding year) and self-reported health.
- Diastolic blood pressure (DBP) levels were measured, categorizing individuals based on hypertension status (untreated DBP >= 100 mm Hg).
Main Results:
- Nonuse of medical care was significantly associated with higher DBP levels in individuals not receiving antihypertensive treatment.
- Approximately 50% of individuals with untreated DBP >= 100 mm Hg had not seen a physician in the past year, irrespective of hypertension awareness.
- This association remained after controlling for demographic factors and self-reported health status.
- Following referral, only 28% of individuals with moderate hypertension (DBP >= 100 mm Hg) visited a physician within 3 months.
Conclusions:
- A substantial proportion of individuals with untreated hypertension do not utilize medical care, indicating a significant barrier to managing high blood pressure.
- Lack of timely medical care access for hypertension is not explained by demographic or self-reported health differences.
- Even after referral, healthcare-seeking behavior for elevated blood pressure remains low, underscoring the need for targeted interventions to improve hypertension control in this population.
Abstract:
We examined the relationship between the use of medical care and diastolic blood pressure (DBP) in 2,939 individuals residing in a rural Southern biracial community. The nonuse of medical care, defined as the absence of reported physician visits in the year preceding the survey, increased with higher levels of DBP among those not receiving antihypertensive treatment. Nearly one half of individuals with untreated DBP greater than or equal to 100 mm Hg had not seen a physician in the preceding year, whether aware of their hypertension or not. The association between nonuse of medical care and untreated diastolic hypertension could not be explained by demographic differences or differences in self-reported health. Despite the fact that all were referred for evaluation of their elevated blood pressure, only 28 per cent of moderate hypertensives (DBP greater than or equal to 100 mm Hg) visited their physician in the 3-month period following the survey. In contrast, 27 per cent of those with DBP less than or equal to 99 mm Hg visited their physician, although few were specifically referred.