Primary Care Providers Perceptions of Racial/Ethnic and Socioeconomic Disparities in Hypertension Control

• Published in: American journal of hypertension 2015-09, Vol.28 (9), p.1091-1097
• Main Authors: Kendrick, Jessica, Nuccio, Eugene, Leiferman, Jenn A., Sauaia, Angela
• Format: Article
• Language: English
• Subjects: Academic Medical Centers; Adult; Antihypertensive Agents - therapeutic use; Attitude of Health Personnel; Awareness; Blood Pressure - drug effects; BP Measurement; Colorado - epidemiology; Communication; Cultural Competency; Female; Health Care Surveys; Health Knowledge, Attitudes, Practice; Healthcare Disparities - economics; Healthcare Disparities - ethnology; Humans; Hypertension - diagnosis; Hypertension - drug therapy; Hypertension - economics; Hypertension - ethnology; Hypertension - physiopathology; Male; Middle Aged; Original; Perception; Primary Health Care - manpower; Professional-Patient Relations; Risk Factors; Socioeconomic Factors; Surveys and Questionnaires; Young Adult
• ISSN: 0895-7061; 1941-7225
• DOI: 10.1093/ajh/hpu294

OBJECTIVE To evaluate the attitudes and perceptions of primary care providers (PCPs) regarding the presence and underlying sources of racial/ethnic and socioeconomic disparities in hypertension control. METHODS We conducted a survey of 115 PCPs from 2 large academic centers in Colorado. We included physicians, nurse practitioners, and physician assistants. The survey assessed provider recognition and perceived contributors of disparities in hypertension control. RESULTS Respondents were primarily female (66%), non-Hispanic White (84%), and physicians (80%). Among respondents, 67% and 73% supported the collection of data on the patients’ race/ethnicity and socioeconomic status (SES), respectively. Eighty-six percent and 89% agreed that disparities in race/ethnicity and SES existed in hypertension care within the US health system. However, only 33% and 44% thought racial/ethnic and socioeconomic disparities existed in the care of their own patients. Providers were more likely to perceive patient factors rather than provider or health system factors as mediators of disparities. However, most supported interventions such as improving provider communication skills (87%) and cultural competency training (89%) to reduce disparities in hypertension control. CONCLUSIONS Most providers acknowledged that racial/ethnic and socioeconomic disparities in hypertension control exist in the US health system, but only a minority reported disparities in care among patients they personally treat. Our study highlights the need for testing an intervention aimed at increasing provider awareness of disparities within the local health setting to improve hypertension control for minority patients.