Hypertension affects all people in the world and, unfortunately, racial disparities only worsen the situation. It is one of the main risk factors for a number of serious diseases that lead to death of over 9.4million people with more than 7% of the global disability-adjusted life-years (Busingye et al., 2014).These diseases are cardiac failure, chronic renal failure, and cerebrovascular disease among many others. The devastating effects of hypertension are connected with the fact that it affects the whole cardiovascular system. In the United States, the situation is worse than in the rest of world. Opara (2010) proves that the disease affects more than 65 million people with African Americans being predisposed the most to it. The risk of developing the disease in black Americans is higher than in white Americans. This research paper aims to discuss health disparities in connection with hypertension, focusing on the African Americans as one of the minority groups in the US.
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Significance of the Problem
In comparison with the white people, black Americans can develop the disease at an early age. Furthermore, they have 1.8 times greater stroke rate, 1.3 times greater rate of nonfatal stroke, 50% greater rate of cardiac failure, 4.2 times greater rate of developing hypertensive end-stage renal disease with overall mortality being 4-5 times higher than that of the white people (Ferdinand & Armani, 2007). The increased prevalence of hypertension among the African Americans compared to other races is a clear indication that this disease is connected with some disparities across the US population. For instance, when compared with other races in the US, people of the African origin are affected by high blood pressure the most. Researches on the development of the disease in children has revealed its association with environmental factors. Taylor, Maddox, and Wu (2009) assert that 43.9% of women and 44.4% of men of non-Hispanic origin have hypertension compared to non-Hispanic white people (30.3% women and 34.1% respectively) and Mexican Americans (30.4% women and 23.1% men respectively).
Causes of Disparities in Hypertension among the African Americans
Many risk factors explain why African Americans suffer from hypertension much more compared to other racial groups. Taylor et al.(2009) explain that genetics play a critical role in predisposing the black Americans to this disease, and their studies show that black people have higher angiotensin, as well as T235 allele, levels than white people. Besides, it is essential to take into account the renin-angiotensin system (RAS). Renin secretion decreases once the kidneys detect high levels of sodium, which results in the increased levels of sodium in the blood, causing hypertension. Low renin activity in African Americans makes them more predisposed to the development of the disease even at an early age (Dreisbach, 2014; Ortega, Sedki, & Nayer, 2015). Low activity levels of this hormone results in the poor prognosis of the disease among this minority group. Redmond, Baer, and Hicks (2011) found that 27.4% of African Americans with high blood pressure have uncontrolled blood pressure more often compared to both non-Hispanic whites and Mexican Americans who account for 17% and 20.2% respectively. Dreisbach (2014) emphasizes that the African Americans have a poorer response to the treatment of hypertension with the help of angiotensin-converting enzyme (ACE) inhibitors than their white counterparts. Moreover, beta blockers are less effective for this population group.
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Furthermore, low socioeconomic status (SES) increases the likelihood of developing the disease in this minority group. African Americans are more likely to have lower socioeconomic status compared to other races. The US Census Bureau found that 33% of this American minority population lived below the poverty line of $20,614 (Taylor et al., 2009). Low SES leads to lower activity levels among the affected population with the subsequent increase in the intake of nutritionally poor, high caloric foods, which enhances the probability of developing obesity, a risk factor for hypertension. Moreover, children from poor backgrounds lack stores that would provide them with nutritious foods and financial resources to be engaged in physical education programs, which predispose them to obesity (Taylor et al., 2009). High prevalence of obesity among the poor makes African Americans highly vulnerable to development of hypertension.
American Nurses Association on the Disparity
Disparities in the field of health, just as in many other fields, appear mainly because of discrimination against different population groups in the form of denial of equal opportunities in healthcare, education, employment, and promotions among many others. Besides, disparities may be common because of some behaviors displayed by the populations, as well as various factors that cannot be influenced, such as genetics. The American Nurses Association (ANA) condemns discrimination in the provision of healthcare services and calls for equal treatment of any person regardless of race and socioeconomic status among others. The ANA realizes that ethnic and racial discrimination persists in healthcare delivery, which negatively impacts both the healthcare environment and those who receive care services (Timothy, 2016). Access to these services is limited for the poor populations, with a significant amount of African Americans suffering from poverty, poor education, and healthcare provider discrimination.
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Unequal distribution of resources across different races is one of the major issues that cause disparities. Such a situation may be attributed to the fact that Africans who live outside the US are less affected by hypertension than those in the US. This means that the environment in the US, including discrimination and inequality, increases the prevalence of this disease. Furthermore, the ANA explains that unequal distribution of resources increases both mortality and morbidity rates, which vary significantly among different racial groups with the minorities suffering the most (Reyes, Hadley, & Davenport, 2013). According to ANA, health resources should be distributed equally across all races and ethnics, and care providers should not promote racial discrimination in their delivery of care. Efforts to address both racial and ethnic disparities in healthcare will require nurses and other providers of healthcare services to develop appropriate approaches to ensure the minorities receive the necessary treatment and are involved in education programs on diabetes and hypertension among many other disease conditions.
Advocating for the African Americans
It is important to ensure that black Americans have equal rights to proper healthcare services because this minority group faces discrimination that results in increased prevalence of the disease or its poor treatment. In my opinion, the black people should be given an opportunity to access healthcare services just as many other races in the nation. This will help them receive quality care services in treating hypertension, which will lessen the disease morbidity and mortality. As mentioned above, the population suffers economic and educational discrimination, which has been attributed to the increase in the prevalence of hypertension. At the same time, most of the black people who receive care from black physicians report excellent services and all their needs are properly addressed compared to situations when they receive care from white physicians (Fuchs, 2011). This shows that racial discrimination is high in the healthcare system. Therefore, this minority group should be advocated for so as to mitigate the high prevalence of hypertension and provide the necessary treatment for those who are already suffering from this disease.
Hypertension affects many people both in the US and in the world as a whole. In the US, the disease prevalence often depends on ethnic and racial aspects of the citizens with African Americans suffering from it the most even though genetics also plays a huge role in the increased prevalence of the disease. Furthermore, this minority group is affected by various socioeconomic factors, including poverty, unemployment, and low-level education, which negatively impact their lifestyles, predisposing them to the disease. This health disparity should be addressed with an immediate effect given that it causes increased morbidity and mortality rates in this group. What is more, the ANA calls for equality in the distribution of resources and delivery of health care services in addressing the disparity. In my opinion, African Americans need advocacy because most of the problems that promote development of hypertension and its devastating nature are caused by discriminatory factors that include low SES and unequal treatment by care providers.