Socio- ecological Assessment

Socio- ecological Assessment

This assignment is going to focus on hypertension among black Americans. Studies have
reported that in African Americans record the highest prevalence of hypertension in the United
States. According to Hicken et al., (2014), approximately 40% of African Americans have been
diagnosed with hypertension. Additionally, hypertension develops early in life and is often very
The issue of hypertension is important in the profession because it is the role of clinicians
across the globe to educate, advice as well as measure peoples’ blood pressure. The education
entails modifying behavior associated with physical activity, diet, stress, weight, alcohol intake,
and smoking. The African Americans are important in this health profession due to the high
prevalence they present with. Clinicians can use the population to study what environmental,
genetic, sociological, economic or even cultural issues that are associated with development of
hypertension. Additionally, practitioners can use the population to study the impact of various
pharmacological as well as non-pharmacological interventions such as effect of smoking
cessation, weight reduction, salt restriction, and physical activity.
Lifestyle is one of the social risk factors that has an impact on development of
hypertension. The hypertensive contribution of alcohol truly matters among African Americans
because alcohol induced hypertension is the most prevalent form of secondary high blood
pressure. A 2012 survey on drug abuse reported that the rate of binge drinking among African
Americans above the 12 years is at 21. 6% compared to the national coverage which stands at 23
percent. The researchers reported that African-American youths are more affected with the risks
associated with alcohol drinking. This can therefore be used to explain the high prevalence of
hypertension among the African American population. Cigarette smoking is another lifestyle

factor that has a significant effect on the etiology of hypertension. About 29.8% of African
Americans have been reported to use tobacco (Jamal et al., 2014). Nicotine in cigarettes is a
major contributor of hypertension development. It acts by narrowing the arteries and hardening
their endothelial wall which eventually increases the heart rate as well as the blood pressure.
Moreover, nicotine cause blood clotting which stresses the heart inducing stroke which worsens
the severity of hypertension (Rasool et al., 2016).
Poverty is another social factor that has been implicated for the high prevalence of
hypertension among African Americans. Studies by Zapolski et al., (2014) have reported that
among the different racial and ethnic populations, African Americans have the highest rates of
poverty at 27.4% followed by the Hispanics at 26% and whites at 10 percent. As healthcare
improves for the wealthy, a reversal socio-economic gradient is seen among the poor,
disadvantaged African Americans who are subjected to the largest burden of hypertension.
Despite the general provision of effective pharmacological interventions for hypertensive
patients in the United States, economies link to the cost: benefit ratio as well as sociological
consideration have a great impact on the low rates of early diagnosis, management, and control
of high blood pressure among the African Americans.
Poverty promotes poor nutrition contributing to etiology of hypertensions. Poor diet is a
risk factor that promotes development of diabetes and obesity. Both diabetes and obesity are
linked with high blood pressure with obese patients recording higher rates of hypertension than
individuals with normal Body Mass Index (BMI). Additionally, obesity increases cardiac
diseases by increasing the levels of Low Density Lipoproteins (LDL) to cholesterol ratio this
prompts the development of hypertension which can cause myocardial infractions as well as

hypertension. Poverty is also associated with stress and depression which increases the release of
cortisol that increases high blood pressure.



Hicken, M. T., Lee, H., Morenoff, J., House, J. S., & Williams, D. R. (2014). Racial/ethnic
disparities in hypertension prevalence: reconsidering the role of chronic stress. American
journal of public health, 104(1), 117-123.
Jamal, A., Agaku, I. T., O’Connor, E., King, B. A., Kenemer, J. B., & Neff, L. (2014). Current
cigarette smoking among adults—United States, 2005–2013. MMWR Morb Mortal Wkly
Rep, 63(47), 1108-1112.
Rasool, A. H., Man, C. N., Sanip, Z. B., Yusoff, H., & Suhaimi, M. Z. (2016). Relationship
between hair nicotine levels with blood pressure, body composition, lipid profile and
leptin among healthy male smokers in Kelantan.
Zapolski, T. C., Pedersen, S. L., McCarthy, D. M., & Smith, G. T. (2014). Less drinking, yet
more problems: Understanding African American drinking and related problems.
Psychological bulletin, 140(1), 188.