Incorporating socio-economic and risk factor diversity into the development of an African-American community blood pressure control program.

OBJECTIVE: To develop culturally competent community based blood pressure control programs for inner-city African Americans.

DESIGN: Cross sectional study of randomly selected households from three experimental and three control communities.

SETTING: Very low, moderately low and moderate socio-economic status (SES) inner-city communities in Chicago, Illinois.

PARTICIPANTS: 957 African Americans adults, aged 18 and over from target communities.

MAIN OUTCOME MEASURE: Household health assessments included employment, education and other demographic information, history of hypertension, disease prevalence, health behaviors, risk factor prevalence, stress, coping/John Henryism, social support, health care utilization and standardized assessments of blood pressure, height, and weight.

RESULTS: There were no significant gender differences in blood pressure levels. Men had more hypertension than women, and women in the very low SES community had significantly more hypertension than women in the moderately low SES community. There was significantly more hypertension overall in the moderately low SES community. Age, education and BMI were the only factors significantly associated with systolic and diastolic blood pressure in all three communities. The very low SES community had significantly more obesity and more uninsured persons than the other communities.

CONCLUSIONS: Intraracial diversity is an important factor to be considered in the development of community blood pressure control programs for African Americans. Age, gender, educational background and SES play a major role in influencing health behaviors and access to health care.